title: Decreasing transobturator sling groin pain without decreasing efficacy using TVT-Abbrevo.
abstract: OBJECTIVE
  Groin pain following a transobturator (TO) midurethral sling is not uncommon and can be difficult to manage. We sought to determine if decreasing the mesh burden in the groin would decrease pain. The primary objective was to compare the incidence of post-operative groin pain following placement of full-length TVT-Obturator versus the shorter TVT-Abbrevo. Secondarily, we aimed to compare the efficacy between both devices 6 months after surgery.
  
  
  METHODS
  This is a retrospective cohort study of all women who underwent a TO midurethral sling by the division of urogynecology at one institution between 1 January 2007 and 31 October 2013. Charts were reviewed and the incidence of post-operative groin pain in the two groups dichotomized as present or absent and compared using a Chi-squared test. Validated questionnaire scores of the groups were compared using t tests.
  
  
  RESULTS
  There were 125 patients who received a TVT-Obturator and 100 patients who received a TVT-Abbrevo. No differences in demographic data were present between the groups. Twelve patients (9.6 %) in the TVT-Obturator group and 1 patient (1 %) in the TVT-Abbrevo group experienced bothersome groin pain (P value = 0.007). The complete pre- and 6-month post-operative ISI, UDI-6 and PFIQ-7 scores were available for 76 (61 %), 47 (38 %), and 45 (36 %) patients following TVT-Obturator and 57 (57 %), 30 (30 %), and 28 (28 %) following TVT-Abbrevo treatment. At 6 months the mean improvement in questionnaire scores for the TVT-Obturator and TVT-Abbrevo groups were as follows: 5.0 and 5.1 for ISI (P value = 0.9), 8.3 and 7.9 for UDI-6 (P value = 0.8), and 4.8 and 6.1 for PFIQ-7 (P value = 0.4).
  
  
  CONCLUSIONS
  Use of TVT-Abbrevo reduces post-operative groin pain compared with the full-length TVT-Obturator, without any reduction in efficacy.
authors.affiliation: Division of Urogynecology, Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Women and Infants Hospital of Rhode Island, 659 Eddy Street, Lower Level, Suite 12, Providence, RI, USA, jsshaw@wihri.org.
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Shaw
authors.forename: Peter C
authors.initials: PC
authors.lastname: Jeppson
authors.forename: Charles R
authors.initials: CR
authors.lastname: Rardin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006119:Groin; D013509:Gynecologic Surgical Procedures / Q000295:instrumentation*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D056887:Pelvic Organ Prolapse / Q000601:surgery; D012189:Retrospective Studies; D012237:Rhode Island / Q000453:epidemiology; D053825:Suburethral Slings / Q000009:adverse effects* / Q000706:statistics & numerical data; D013526:Surgical Mesh / Q000009:adverse effects; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery