Muhammed Sulukaya

Safety and Efficacy of Retropubic or Transobturator Midurethral Slings in a Randomized Cohort of Turkish Women

Objective: The aim of this study was to evaluate the safety and efficacy of retropubic (RP) or transobturator (TO) midurethral slings (MUS) in a prospective randomized cohort of Turkish women. Patients and Methods: A total of 54 women with urodynamic stress urinary incontinence (SUI) were randomized to undergo either RP or TO MUS between August 2006 and February 2013 in a tertiary referral center by a single surgeon. All patients had history, physical examination, urodynamic evaluation and quality of life assessments. The validated Turkish versions of the SEAPI, ICIQ-SF and OAB-V8 questionnaires were used. The Advantage® RP and the Obtryx® TO MUS Systems were used for all RP and TO procedures. Results: Twenty-seven patients were randomized to each group. The median follow-up was 48.5 ± 21.8 months. The median hospital stay was 24.0 ± 4.8 h and median operative time was 35.0 ± 19.9 min. The overall objective and subjective cure rates were 92.6 and 79.6%, respectively. The quality of life of all patients significantly increased after the operation compared to their preoperative status. Patients with a poorer subjective cure rate were those with mixed urinary incontinence, whose preoperative SEAPI and OAB-V8 scores were significantly higher. Conclusion: MUS surgery is highly effective and could safely be performed in a cohort of Turkish women with SUI in subspecialty centers by experienced surgeons. There is no significant difference between RP or TO applications in terms of safety and efficacy. Further studies with long-term follow-up data are required.

PD35-07 PRELIMINARY RESULTS OF A PROSPECTIVE RANDOMIZED TRIAL OF SAFETY GUIDEWIRE USE IN URETEROSCOPIC STONE SURGERY: TO USE OR NOT TO USE

INTRODUCTION AND OBJECTIVES: Up-to-date, urology guidelines introduce safety guidewire (SGW) as an integral tool in ureteroscopy and recommended its routine use. However, the necessity of SGW placement in endourological procedures lack evidence and is being suggested as an expert opinion. Present study aimed to evaluate the use of SGW placement and its necessity in treatment of ureteral stones with semi-rigid ureteroscopy (s-URS). METHODS: A total of 160 patients with ureteral stones were stratified according to ureteral stone location and prospectively randomized into two groups’ according to SGW usage or not in s-URS between July 2014 and August 2016. Ureteroscopy and litotripsy were done with a semi-rigid ureteroscope of 6.4/7.8 Fr (Olympus) and laser. Chi-square and student t-test were used for comparing data. RESULTS: Of all patients, in 79 interventions were done under the guidance of SGW (SGW group) and in 81 without the guidance of SGW (NoSGW group). In No-SGW group 10 patients needed SGW introduction as it was difficult to access or advance the ureteroscope into the ureteral orifice or throughout the ureter and in SGW group SGW could not be introduced in 8 patients. These patients were excluded from the study. There were no significant differences in patient demographics and findings between the two groups, except female/male patient ratio and mean BMI which was higher in the SGW group (Table 1-2). Among all patients only 1 patient (1.3%) in SGW group experienced a complication of Clavien 3 and/or higher, which was ureteral perforation. CONCLUSIONS: The preliminary results of our study reveal that, routine use of SGW placement does not help to decrease complication and/or treatment failure rates. Safety guidewire concept has to be re-evaluated with further prospective randomized trials. Source of Funding: None