Objectives To evaluate for the first time in the literature the learning curve of Inside-out transobturator tape (TVT-O™). Study design A prospective observational study was conducted in a tertiary reference center. Consecutive women treated by TVT-O™ performed by one surgeon were included. Data regarding subjective, objective cure rates, and adverse events were collected. Trends, over the number of procedures, were estimated using assay analyses. Number of procedures and variables were interpolating in standard curves using linear lines. Results Three hundred and seventy two procedures were included. Postoperative pain levels decreased with the increase in the level of expertise (pain levels: 1-day: from 6.6 (±3.3) to 4.3 (±3.1); 95%CI: -0.01603 to 0.001235, p = 0.04; 2-day: from 5.6 (±4.1) to 3.6 (±3.7); 95%CI: -0.02092 to -0.002497, p = 0.01; 12-month: from 0.1 (±0.7) to 0 (±0); 95%CI: -0.001814 to 0.05019, p = 0.07). Overall, objective cure rate was achieved in 93.5% of patients. Additionally, 88.2% and 88.7% patients reported "much better" feeling at PGI-I scale and 80% reduction in UDI score, respectively. We observed, that delta ICIQ-sf (from 12 (±8.7) to 14 (±6.0); p = 0.04) and delta-UDI (from 91% to 97%; p = 0.04) improved over the time. Conclusions TVT-O procedure offers excellent outcomes with high objective and subjective cure rates and low complications rate, even at the beginning of the surgeon's learning curve. However, a high experience of the surgeon could significantly improve the subjective cure rate and could reduce postoperative the groin pain.

Is there a learning curve for the TVT-O procedure? A prospective single-surgeon study of 372 consecutive cases / Serati, M; Bogani, G; Braga, A; Sorice, P; Salvatore, S; Uccella, S; Ghezzi, F. - In: EUROPEAN JOURNAL OF OBSTETRICS, GYNECOLOGY, AND REPRODUCTIVE BIOLOGY. - ISSN 0301-2115. - 186:(2015), pp. 85-90. [10.1016/j.ejogrb.2015.01.008]

Is there a learning curve for the TVT-O procedure? A prospective single-surgeon study of 372 consecutive cases

Bogani G;
2015

Abstract

Objectives To evaluate for the first time in the literature the learning curve of Inside-out transobturator tape (TVT-O™). Study design A prospective observational study was conducted in a tertiary reference center. Consecutive women treated by TVT-O™ performed by one surgeon were included. Data regarding subjective, objective cure rates, and adverse events were collected. Trends, over the number of procedures, were estimated using assay analyses. Number of procedures and variables were interpolating in standard curves using linear lines. Results Three hundred and seventy two procedures were included. Postoperative pain levels decreased with the increase in the level of expertise (pain levels: 1-day: from 6.6 (±3.3) to 4.3 (±3.1); 95%CI: -0.01603 to 0.001235, p = 0.04; 2-day: from 5.6 (±4.1) to 3.6 (±3.7); 95%CI: -0.02092 to -0.002497, p = 0.01; 12-month: from 0.1 (±0.7) to 0 (±0); 95%CI: -0.001814 to 0.05019, p = 0.07). Overall, objective cure rate was achieved in 93.5% of patients. Additionally, 88.2% and 88.7% patients reported "much better" feeling at PGI-I scale and 80% reduction in UDI score, respectively. We observed, that delta ICIQ-sf (from 12 (±8.7) to 14 (±6.0); p = 0.04) and delta-UDI (from 91% to 97%; p = 0.04) improved over the time. Conclusions TVT-O procedure offers excellent outcomes with high objective and subjective cure rates and low complications rate, even at the beginning of the surgeon's learning curve. However, a high experience of the surgeon could significantly improve the subjective cure rate and could reduce postoperative the groin pain.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1584328
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