title: Surgeon-tailored polypropylene mesh as a needleless single-incision sling versus TVT-O for the treatment of female stress urinary incontinence: a comparative study.
abstract: OBJECTIVE
  To compare safety and efficacy of surgeon-tailored polypropylene mesh through needleless single-incision technique (STM) versus tension-free vaginal tape-obturator (TVT-O) aiming to decrease cost of treatment of stress urinary incontinence (SUI). This is important in developing countries due to limited healthcare resources.
  
  
  METHODS
  A retrospective cohort study was done at Urology and Gynecology Departments (dual-center), Cairo University, from January 2011 to August 2013. STM was inserted in 72 females, while TVT-O was inserted in 48 females. Females evaluated by cough stress test, stress and urge incontinence quality of life questionnaire (SUIQQ), Q max and abdominal leak point pressure (ALPP) were included. Different factors were compared between both groups using paired t, Wilcoxon's signed rank, McNemar, Chi-square, Fisher's exact, independent t or Mann-Whitney tests.
  
  
  RESULTS
  Age, parity, previous surgeries, ALPP, intrinsic sphincter deficiency (ISD), associated prolapse and associated prolapse repair were comparable in both groups. No significant difference was found between both groups in postoperative complications (except groin pain), cure, SUIQQ indices improvement and Q max decline. In total, 65 (90 %) cured, 6 (8 %) improved while failure was detected in one (1 %) patient in STM group, while 42 (87 %) cured, 4 (8 %) improved and failure was detected in two (4 %) patients in TVT-O group. Presence of ISD (p = 0.565), urgency (p = 0.496), UUI (p = 0.531), previous surgeries (p = 0.345), associated urogenital prolapse (p = 0.218) or associated prolapse repair (p = 0.592) did not lead to any significant difference in outcome between both groups. Cost of mesh decreased from US$500 (TVT-O) to US$10 (STM).
  
  
  CONCLUSIONS
  Outcome of STM is comparable to TVT-O. Furthermore, STM is more economic.
authors.affiliation: Urology Department, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt, mohammedshemy@yahoo.com.
authors.forename: Mohammed S
authors.initials: MS
authors.lastname: ElSheemy
authors.forename: Hesham
authors.initials: H
authors.lastname: Fathy
authors.forename: Hussein A
authors.initials: HA
authors.lastname: Hussein
authors.forename: Eman A
authors.initials: EA
authors.lastname: Hussein
authors.forename: Sarah Mohamed
authors.initials: SM
authors.lastname: Hassan
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004867:Equipment Design; D005260:Female; D006801:Humans; D008875:Middle Aged; D009339:Needles; D011126:Polypropylenes; D012189:Retrospective Studies; D053825:Suburethral Slings; D013526:Surgical Mesh / Q000009:adverse effects; D011795:Surveys and Questionnaires; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods; D014572:Urology
chemical_list: D011126:Polypropylenes