Aim: To use urodynamic evaluation to compare the effectiveness of modified midurethral sling, tension-free vaginal tape, and transobturator tape in the treatment of stress urinary incontinence.
Materials and Methods: A total of 65 patients with stress urinary incontinence underwent midurethral sling operations between 2003 and 2012. Preoperative and postoperative urodynamic evaluation data were analyzed. Cystometry was used to determine the cure rates of operations. Valsalva leak point pressure was obtained to assess and compare the objective cure rates.
Results: No significant differences were noted between different operation types. Objective cure rates of procedures were established as 83.3%, 88.9%, and 91.3% for modified midurethral sling, tension-free vaginal tape, and transobturator tape, respectively. Tension-free vaginal tape was more effective in intrinsic sphincteric deficiency than other operation types. Valsalva leak point pressure showed the effectiveness of the operations. According to pressure values, stress urinary incontinence were cured or improved in patients objectively. Only 8 patients had positive Valsalva leak point pressure postoperatively and the mean of postoperative Valsalva leak point pressure values was higher than that of preoperative levels.
Discussion: Effectiveness of midurethral sling operations did not differ between groups. Valsalva leak point pressure is an important marker to determine objective cure rates. Modified midurethral sling techniques are more economical with comparable success rates.
Key Words: modified midurethral sling, stress urinary incontinence, tension-free vaginal tape, transobturator tape, Valsalva leak point pressure