title: Safety and efficacy of retropubic or transobturator midurethral slings in a randomized cohort of Turkish women.
abstract: OBJECTIVE
  The aim of this study was to evaluate the safety and efficacy of retropubic (RP) or transobturator (TO) midurethral slings (MUS) in a prospective randomized cohort of Turkish women.
  
  
  METHODS
  A total of 54 women with urodynamic stress urinary incontinence (SUI) were randomized to undergo either RP or TO MUS between August 2006 and February 2013 in a tertiary referral center by a single surgeon. All patients had history, physical examination, urodynamic evaluation and quality of life assessments. The validated Turkish versions of the SEAPI, ICIQ-SF and OAB-V8 questionnaires were used. The Advantage® RP and the Obtryx® TO MUS Systems were used for all RP and TO procedures.
  
  
  RESULTS
  Twenty-seven patients were randomized to each group. The median follow-up was 48.5 ± 21.8 months. The median hospital stay was 24.0 ± 4.8 h and median operative time was 35.0 ± 19.9 min. The overall objective and subjective cure rates were 92.6 and 79.6%, respectively. The quality of life of all patients significantly increased after the operation compared to their preoperative status. Patients with a poorer subjective cure rate were those with mixed urinary incontinence, whose preoperative SEAPI and OAB-V8 scores were significantly higher.
  
  
  CONCLUSIONS
  MUS surgery is highly effective and could safely be performed in a cohort of Turkish women with SUI in subspecialty centers by experienced surgeons. There is no significant difference between RP or TO applications in terms of safety and efficacy. Further studies with long-term follow-up data are required.
authors.affiliation: Department of Urology, Marmara University School of Medicine, Istanbul, Turkey.
authors.forename: Tufan
authors.initials: T
authors.lastname: Tarcan
authors.forename: Naside
authors.initials: N
authors.lastname: Mangir
authors.forename: Ahmet
authors.initials: A
authors.lastname: Sahan
authors.forename: Yiloren
authors.initials: Y
authors.lastname: Tanidir
authors.forename: Muhammed
authors.initials: M
authors.lastname: Sulukaya
authors.forename: Yalcin
authors.initials: Y
authors.lastname: İlker
mesh_terms: D005260:Female; D006801:Humans; D007902:Length of Stay; D061646:Operative Time; D011446:Prospective Studies; D011474:Prosthesis Design; D011788:Quality of Life; D012737:Sex Factors; D053825:Suburethral Slings; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey; D001743:Urinary Bladder / Q000503:physiopathology / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation*