title: The Effect of Patient Position during Mid-Urethral Sling Operations on the Postoperative Outcomes of Sling Success: A Randomized Clinical Study.
abstract: OBJECTIVE
  To determine and compare the effectiveness, peri- and postoperative outcomes of mid-urethral sling (MUS) operations for urinary incontinence, using 2 different patient positions during surgery.
  
  
  METHODS
  In this study, 146 patients underwent MUS surgery in a urogynecology clinic. Of them, 72 patients underwent the intraoperative surgical procedure of reverse trendelenburg patient positioning for tape adjustment (group 1) and the remaining 74 patients had the routine surgical procedure of MUS surgery (group 2). The primary outcome was the evaluation of postoperative urine leaks, using the stress test, and secondary outcomes were quality of life, using the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF, Turkish version) and complication rates.
  
  
  RESULTS
  There were no significant differences in demographic variables between the 2 groups. The overall cure rates for incontinence in the lithotomy position was 97.22 and 85.13% for groups 1 and 2, respectively, in which group 1 had a statistically significant decrease in urine leak postoperatively (p < 0.05; OR 3.08, 95% CI 2.78-22.14). The postoperative ICQ-SF scores showed no significant difference between the 2 groups (p = 0.19).
  
  
  CONCLUSIONS
  Applying a 45-degree reverse trendelenburg position for tape adjusting during MUS operation results in a greater objective cure rate compared with the typical dorsolithotomy position; however, there was no difference in the subjective outcome.
authors.affiliation: Kanuni Sultan Sx00FC;leyman Research and Teaching Hospital, Department of Gynecology, Istanbul, Turkey.
authors.forename: Agahan
authors.initials: A
authors.lastname: Han
authors.forename: Erbil
authors.initials: E
authors.lastname: Karaman
authors.forename: İsmet
authors.initials: İ
authors.lastname: Alkiş
authors.forename: Hasan Cemal
authors.initials: HC
authors.lastname: Ark
authors.forename: Aysu
authors.initials: A
authors.lastname: Akça
authors.forename: Ceyhun
authors.initials: C
authors.lastname: Numanoğlu
authors.forename: Betül Büyükkaya
authors.initials: BB
authors.lastname: Alptekin
authors.forename: Aysun Fendal
authors.initials: AF
authors.lastname: Tunca
mesh_terms: D000328:Adult; D005260:Female; D018475:Head-Down Tilt; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011187:Posture; D011788:Quality of Life; D053825:Suburethral Slings; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000453:epidemiology / Q000601:surgery; D013520:Urologic Surgical Procedures / Q000379:methods*