Efficacy/Safety of Midurethral Sling

NCT ID: NCT05255289

Last Updated: 2025-09-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-03-08

Study Completion Date

2026-03-31

Brief Summary

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The trans-obturator tape (TOT), which exhibits a satisfactory cure rate and a relatively diminished invasiveness, has been increasingly accepted as a surgical treatment of stress urinary incontinence (SUI) patients. Nevertheless, in contrast to the well-recognized therapeutic benefit of the enhanced resistance to the bladder continence during urine storage, if the voiding function of the bladder adapts to the TOT-enhanced outlet resistance has not been adequately investigated. This study retrospectively assayed the voiding efficacy of each voiding cycle, to clarify if the thermodynamic efficacy of the bladder was modified in response to the TOT surgery.

Detailed Description

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The urodynamic study included free uroflowmetry, postvoid residual, filling and voiding cystometry, and a urethral pressure profile. The filling cystometry and urethral pressure profile were performed with 37 degrees C normal saline similar to body temperature at an infusion rate of 80 ml/min. All patients received a pre- and a post-operative urodynamic evaluation, in which pre-operative evaluation was conducted 1-4 weeks before TOT procedure, and post-operative evaluation was done at 4-6 weeks follow-up.

Complete multichannel urodynamic studies including free uroflowmetry, filling and voiding cystometry, and urethral pressure profile was performed in each patient. The urodynamic parameters measured were the maximum flow rate (Qmax), voided volume, post-void residual volume (PVR), and detrusor pressure at Qmax (Pdet. Qmax). The filling cystometry and urethral pressure profile were performed with 37 degrees C normal saline at an infusion rate of 80 ml/min. All data were recorded and analyzed using a Medical Measurement Systems (MMS UD-200, Enschede, The Netherlands). All data in this study will be expressed as mean ± SEM. After checking the normality and variance of data, two-way ANOVAs were used to assess the difference in values among testing groups and time points; and post hoc Student-Newman-Keuls tests were used to compare the means of groups when there was a significant difference between groups. Significance was set at p\<0.05.

Conditions

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Stress Urinary Incontinence

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Before TOT

Data obtained before the operation

Group Type EXPERIMENTAL

Urodynamic investigations before and after a trans-obturator tape protocol.

Intervention Type PROCEDURE

Urodynamic investigations (The urodynamic study included free uroflowmetry, postvoid residual, filling and voiding cystometry, and a urethral pressure profile. The filling cystometry and urethral pressure profile were performed with 37 degrees C normal saline similar to body temperature at an infusion rate of 80 ml/min.)

After TOT

Data obtained after the operation

Group Type EXPERIMENTAL

Urodynamic investigations before and after a trans-obturator tape protocol.

Intervention Type PROCEDURE

Urodynamic investigations (The urodynamic study included free uroflowmetry, postvoid residual, filling and voiding cystometry, and a urethral pressure profile. The filling cystometry and urethral pressure profile were performed with 37 degrees C normal saline similar to body temperature at an infusion rate of 80 ml/min.)

Before TVT-O

Data obtained before the operation.

Group Type EXPERIMENTAL

Urodynamic investigations before and after a tension-free vaginal tape-obturator (TVT-O)

Intervention Type PROCEDURE

Urodynamic investigations (stated above.)

After TVT-O

Data obtained after the operation.

Group Type EXPERIMENTAL

Urodynamic investigations before and after a tension-free vaginal tape-obturator (TVT-O)

Intervention Type PROCEDURE

Urodynamic investigations (stated above.)

Aged patient (>50 y/o) before TVT-O

Data obtained before the operation.

Group Type EXPERIMENTAL

Urodynamic investigations before and after a tension-free vaginal tape-obturator (TVT-O)

Intervention Type PROCEDURE

Urodynamic investigations (stated above.)

Aged patient (>50 y/o) after TVT-O

Data obtained after the operation.

Group Type EXPERIMENTAL

Urodynamic investigations before and after a tension-free vaginal tape-obturator (TVT-O)

Intervention Type PROCEDURE

Urodynamic investigations (stated above.)

Young patients (<50 y/o) before TVT-O

Data obtained before the operation.

Group Type EXPERIMENTAL

Urodynamic investigations before and after a tension-free vaginal tape-obturator (TVT-O)

Intervention Type PROCEDURE

Urodynamic investigations (stated above.)

Young patients (<50 y/o) after TVT-O

Data obtained after the operation.

Group Type EXPERIMENTAL

Urodynamic investigations before and after a tension-free vaginal tape-obturator (TVT-O)

Intervention Type PROCEDURE

Urodynamic investigations (stated above.)

Menopausal patient before TVT-O

Data obtained before the operation.

Group Type EXPERIMENTAL

Urodynamic investigations before and after a tension-free vaginal tape-obturator (TVT-O)

Intervention Type PROCEDURE

Urodynamic investigations (stated above.)

Menopausal patient after TVT-O

Data obtained after the operation.

Group Type EXPERIMENTAL

Urodynamic investigations before and after a tension-free vaginal tape-obturator (TVT-O)

Intervention Type PROCEDURE

Urodynamic investigations (stated above.)

Pre-menopausal patient before TVT-O

Data obtained before the operation.

Group Type EXPERIMENTAL

Urodynamic investigations before and after a tension-free vaginal tape-obturator (TVT-O)

Intervention Type PROCEDURE

Urodynamic investigations (stated above.)

Pre-menopausal patients after TVT-O

Data obtained after the operation.

Group Type EXPERIMENTAL

Urodynamic investigations before and after a tension-free vaginal tape-obturator (TVT-O)

Intervention Type PROCEDURE

Urodynamic investigations (stated above.)

Before i-STOP

Data obtained before the operation.

Group Type EXPERIMENTAL

Urodynamic investigations before and after an i-STOP mini adjustable sling protocol.

Intervention Type PROCEDURE

Urodynamic investigations (stated above)

After i-STOP

Data obtained after the operation.

Group Type EXPERIMENTAL

Urodynamic investigations before and after an i-STOP mini adjustable sling protocol.

Intervention Type PROCEDURE

Urodynamic investigations (stated above)

Aged patient before i-STOP

Data obtained before the operation.

Group Type EXPERIMENTAL

Urodynamic investigations before and after an i-STOP mini adjustable sling protocol.

Intervention Type PROCEDURE

Urodynamic investigations (stated above)

Aged patient after i-STOP

Data obtained after the operation.

Group Type EXPERIMENTAL

Urodynamic investigations before and after an i-STOP mini adjustable sling protocol.

Intervention Type PROCEDURE

Urodynamic investigations (stated above)

Young patient before i-STOP

Data obtained before the operation.

Group Type EXPERIMENTAL

Urodynamic investigations before and after an i-STOP mini adjustable sling protocol.

Intervention Type PROCEDURE

Urodynamic investigations (stated above)

Young patient after i-STOP

Data obtained after the operation.

Group Type EXPERIMENTAL

Urodynamic investigations before and after an i-STOP mini adjustable sling protocol.

Intervention Type PROCEDURE

Urodynamic investigations (stated above)

Menopausal patient before i-STOP

Data obtained before the operation.

Group Type EXPERIMENTAL

Urodynamic investigations before and after an i-STOP mini adjustable sling protocol.

Intervention Type PROCEDURE

Urodynamic investigations (stated above)

Menopausal patient after i-STOP

Data obtained after the operation.

Group Type EXPERIMENTAL

Urodynamic investigations before and after an i-STOP mini adjustable sling protocol.

Intervention Type PROCEDURE

Urodynamic investigations (stated above)

Pre-menopausal patient before i-STOP

Data obtained before the operation.

Group Type EXPERIMENTAL

Urodynamic investigations before and after an i-STOP mini adjustable sling protocol.

Intervention Type PROCEDURE

Urodynamic investigations (stated above)

Pre-menopausal patient after i-STOP

Data obtained after the operation.

Group Type EXPERIMENTAL

Urodynamic investigations before and after an i-STOP mini adjustable sling protocol.

Intervention Type PROCEDURE

Urodynamic investigations (stated above)

Before mini Arc

Data obtained before the operation.

Group Type EXPERIMENTAL

Urodynamic investigations before and after a mini Arc protocol.

Intervention Type PROCEDURE

Urodynamic investigations (stated above)

After mini Arc

Data obtained after the operation.

Group Type EXPERIMENTAL

Urodynamic investigations before and after a mini Arc protocol.

Intervention Type PROCEDURE

Urodynamic investigations (stated above)

Age patient before mini Arc

Data obtained before the operation.

Group Type EXPERIMENTAL

Urodynamic investigations before and after a mini Arc protocol.

Intervention Type PROCEDURE

Urodynamic investigations (stated above)

Age patient after mini Arc

Data obtained after the operation.

Group Type EXPERIMENTAL

Urodynamic investigations before and after a mini Arc protocol.

Intervention Type PROCEDURE

Urodynamic investigations (stated above)

Young before mini Arc

Data obtained before the operation.

Group Type EXPERIMENTAL

Urodynamic investigations before and after a mini Arc protocol.

Intervention Type PROCEDURE

Urodynamic investigations (stated above)

Young patient after mini Arc

Data obtained after the operation.

Group Type EXPERIMENTAL

Urodynamic investigations before and after a mini Arc protocol.

Intervention Type PROCEDURE

Urodynamic investigations (stated above)

Menopausal patient before mini Arc

Data obtained before the operation.

Group Type EXPERIMENTAL

Urodynamic investigations before and after a mini Arc protocol.

Intervention Type PROCEDURE

Urodynamic investigations (stated above)

Menopausal patient after mini Arc

Data obtained after the operation.

Group Type EXPERIMENTAL

Urodynamic investigations before and after a mini Arc protocol.

Intervention Type PROCEDURE

Urodynamic investigations (stated above)

Pre-menopausal before mini Arc

Data obtained before the operation.

Group Type EXPERIMENTAL

Urodynamic investigations before and after a mini Arc protocol.

Intervention Type PROCEDURE

Urodynamic investigations (stated above)

Pre-menopausal patient after mini Arc

Data obtained after the operation.

Group Type EXPERIMENTAL

Urodynamic investigations before and after a mini Arc protocol.

Intervention Type PROCEDURE

Urodynamic investigations (stated above)

Before Solyx sling

Data obtained before the operation

Group Type EXPERIMENTAL

Urodynamic investigations before and after an Solyx sling protocol.

Intervention Type PROCEDURE

Urodynamic investigations (stated above.)

After Solyx sling

Data obtained before the operation

Group Type EXPERIMENTAL

Urodynamic investigations before and after an Solyx sling protocol.

Intervention Type PROCEDURE

Urodynamic investigations (stated above.)

Interventions

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Urodynamic investigations before and after a trans-obturator tape protocol.

Urodynamic investigations (The urodynamic study included free uroflowmetry, postvoid residual, filling and voiding cystometry, and a urethral pressure profile. The filling cystometry and urethral pressure profile were performed with 37 degrees C normal saline similar to body temperature at an infusion rate of 80 ml/min.)

Intervention Type PROCEDURE

Urodynamic investigations before and after a tension-free vaginal tape-obturator (TVT-O)

Urodynamic investigations (stated above.)

Intervention Type PROCEDURE

Urodynamic investigations before and after a mini Arc protocol.

Urodynamic investigations (stated above)

Intervention Type PROCEDURE

Urodynamic investigations before and after an i-STOP mini adjustable sling protocol.

Urodynamic investigations (stated above)

Intervention Type PROCEDURE

Urodynamic investigations before and after an Solyx sling protocol.

Urodynamic investigations (stated above.)

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Clinical diagnosis of stress urinary incontience
* Have urodynamic investigations before and after operation.
Minimum Eligible Age

30 Years

Maximum Eligible Age

100 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Mackay Medical College

OTHER

Sponsor Role lead

Responsible Party

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Chin-Tsung Shen

Head of administration

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Yi-Shing Leu, M.D.

Role: STUDY_CHAIR

Department of Ear, Nose, and Throat, MacKay Memorial Hospital, Taipei, Taiwan

Locations

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Department of Obstetrics and Gynecology

New Taipei City, , Taiwan

Site Status RECRUITING

Countries

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Taiwan

Central Contacts

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Hui-Hsuan Lau, M.D.

Role: CONTACT

+886-975-835928

Facility Contacts

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Hui-Hsuan Lau, PhD

Role: primary

+886 975-835928

References

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Abrams P, Andersson KE, Apostolidis A, Birder L, Bliss D, Brubaker L, Cardozo L, Castro-Diaz D, O'Connell PR, Cottenden A, Cotterill N, de Ridder D, Dmochowski R, Dumoulin C, Fader M, Fry C, Goldman H, Hanno P, Homma Y, Khullar V, Maher C, Milsom I, Newman D, Nijman RJM, Rademakers K, Robinson D, Rosier P, Rovner E, Salvatore S, Takeda M, Wagg A, Wagner T, Wein A; members of the committees. 6th International Consultation on Incontinence. Recommendations of the International Scientific Committee: EVALUATION AND TREATMENT OF URINARY INCONTINENCE, PELVIC ORGAN PROLAPSE AND FAECAL INCONTINENCE. Neurourol Urodyn. 2018 Sep;37(7):2271-2272. doi: 10.1002/nau.23551. Epub 2018 Aug 14. No abstract available.

Reference Type BACKGROUND
PMID: 30106223 (View on PubMed)

Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Victor A, Wein A; Standardisation Sub-committee of the International Continence Society. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002;21(2):167-78. doi: 10.1002/nau.10052. No abstract available.

Reference Type BACKGROUND
PMID: 11857671 (View on PubMed)

Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, Van Kerrebroeck P, Victor A, Wein A; Standardisation Sub-Committee of the International Continence Society. The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology. 2003 Jan;61(1):37-49. doi: 10.1016/s0090-4295(02)02243-4. No abstract available.

Reference Type BACKGROUND
PMID: 12559262 (View on PubMed)

Atis G, Arisan S, Ozagari A, Caskurlu T, Dalkilinc A, Ergenekon E. Tissue reaction of the rat urinary bladder to synthetic mesh materials. ScientificWorldJournal. 2009 Oct 2;9:1046-51. doi: 10.1100/tsw.2009.120.

Reference Type BACKGROUND
PMID: 19802500 (View on PubMed)

de Leval J. Novel surgical technique for the treatment of female stress urinary incontinence: transobturator vaginal tape inside-out. Eur Urol. 2003 Dec;44(6):724-30. doi: 10.1016/j.eururo.2003.09.003.

Reference Type BACKGROUND
PMID: 14644127 (View on PubMed)

Hsiao SM, Kuo HC. Predictors of further anti-incontinence interventions or transvaginal urethrolysis after a pubovaginal sling procedure in women with and without neurologic disorders. J Formos Med Assoc. 2021 Jul;120(7):1464-1477. doi: 10.1016/j.jfma.2020.12.029. Epub 2021 Jan 16.

Reference Type BACKGROUND
PMID: 33468403 (View on PubMed)

Huang WC, Lau HH, Su TH. Did surgical failure and complications affect incontinence-related quality of life in women after transobturator sling procedure? Taiwan J Obstet Gynecol. 2018 Apr;57(2):295-299. doi: 10.1016/j.tjog.2018.02.020.

Reference Type BACKGROUND
PMID: 29673676 (View on PubMed)

Medina CA, Costantini E, Petri E, Mourad S, Singla A, Rodriguez-Colorado S, Ortiz OC, Doumouchtsis SK. Evaluation and surgery for stress urinary incontinence: A FIGO working group report. Neurourol Urodyn. 2017 Feb;36(2):518-528. doi: 10.1002/nau.22960. Epub 2016 Mar 7.

Reference Type BACKGROUND
PMID: 26950893 (View on PubMed)

Schimpf MO, Rahn DD, Wheeler TL, Patel M, White AB, Orejuela FJ, El-Nashar SA, Margulies RU, Gleason JL, Aschkenazi SO, Mamik MM, Ward RM, Balk EM, Sung VW; Society of Gynecologic Surgeons Systematic Review Group. Sling surgery for stress urinary incontinence in women: a systematic review and metaanalysis. Am J Obstet Gynecol. 2014 Jul;211(1):71.e1-71.e27. doi: 10.1016/j.ajog.2014.01.030. Epub 2014 Jan 30.

Reference Type BACKGROUND
PMID: 24487005 (View on PubMed)

Ulmsten U, Henriksson L, Johnson P, Varhos G. An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 1996;7(2):81-5; discussion 85-6. doi: 10.1007/BF01902378.

Reference Type BACKGROUND
PMID: 8798092 (View on PubMed)

Waltregny D, Gaspar Y, Reul O, Hamida W, Bonnet P, de Leval J. TVT-O for the treatment of female stress urinary incontinence: results of a prospective study after a 3-year minimum follow-up. Eur Urol. 2008 Feb;53(2):401-8. doi: 10.1016/j.eururo.2007.08.021. Epub 2007 Aug 21.

Reference Type BACKGROUND
PMID: 17728052 (View on PubMed)

Lau HH, Lai CY, Peng HY, Hsieh MC, Su TH, Lee JJ, Lin TB. Modification of bladder thermodynamics in stress urinary incontinence patients submitted to trans-obturator tape: A retrospective study based on urodynamic assessment. Front Bioeng Biotechnol. 2022 Aug 19;10:912602. doi: 10.3389/fbioe.2022.912602. eCollection 2022.

Reference Type DERIVED
PMID: 36061421 (View on PubMed)

Related Links

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https://bcmj.org/sites/default/files/public/BCMJ_49_Vol9_articles_reported_complications.pdf

Reported complications of tension-free vaginal tape procedures: A review

Other Identifiers

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20MMHIS410e

Identifier Type: -

Identifier Source: org_study_id

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