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O692 COMPARISON OF TVT-O AND TVT-ABBREVO FOR THE SURGICAL MANAGEMENT OF FEMALE STRESS URINARY INCONTINENCE: A 12-MONTHS PRELIMINARY STUDY
S504
Free communication (oral) presentations / International Journal of Gynecology & Obstetrics 119S3 (2012) S261–S530
Questionnaire (KHQ) and a urinary diary were performed before and 12 months after procedure. Results: 25 patients (10 for TVT-O and 13 for TVT-Secur) were lost at follow-up, leaving a total of 80 patients for TVT-O and 77 for TVT-Secur. Duration of the procedure was significantly lower in the TVT-Secur group (7.8±1.1 minutes vs. 12.8±2.4 minutes; p < 0.05). Blood loss was not different, even though patients from the TVTSecur group tended to have higher percentage of moderate blood loss. A case of severe blood loss was observed in the TVT-Secur group, even though transient. Time to first voiding was significantly higher in the TVT-O group in comparison with TVT-Secur group (90.4±33.5 min. vs. 61.2±1.9 min.; p < 0.05). Objective cure were 86.2% for TVT-O and 80.5% for TVT-Secur (p NS). No intra-operative complications were observed in the two groups. The most frequent post-operative complications was transient leg pain (3 cases; 3.7%) for TVT-O and de novo urgency (5 cases; 6.5%) for TVT-Secur. Two cases of vaginal erosion by the tape was observed in the TVT-Secur group and one in the TVT-O. Post-operative pain VAS scoring was significantly lower in the TVT-Secur group in comparison with the TVT-O group (p < 0.05). Conclusions: Both techniques appear to be safe and effective. TVTSecur shortened operative time and reduced bladder obstruction and thigh pain, but has higher de novo urgency rates. There seems not to be a significant decline in efficacy three years after the procedure in both groups. O692 COMPARISON OF TVT-O AND TVT-ABBREVO FOR THE SURGICAL MANAGEMENT OF FEMALE STRESS URINARY INCONTINENCE: A 12-MONTHS PRELIMINARY STUDY G.A. Tommaselli1 , A. D’Afiero2 , C. Formisano1 , A. Fabozzi1 , C. Di Carlo1 , C. Nappi1 . 1 Obstetrics and Gynecology, University of Naples ‘Federico II’, Naples, Italy; 2 Ospedale S. Maria della Piet` a, Casoria, Italy Objectives: To compare TVT-O (Ethicon Women’s Health and Urology) with a modified device with the same trajectory, but with a reduced length (TVT-Abbrevo, Ethicon Women’s Health and Urology). Materials: Seventy-eight women were enrolled for this prospective study. Inclusion criteria were stress urinary incontinence (SUI) diagnosed at challenge stress test (CST) with urethral hypermobility, and at urodynamics; sign of the informed consent to randomization, surgical procedure and choosen type of anesthesia. Exclusion criteria were isolated or predominant urge incontinence; genital prolapse >2 stage according PoP-Q; severe contraindications to surgical procedures; incapacity of giving informed consent to randomization, surgical procedure and choosen type of anesthesia. Methods: Patients preoperatively underwent general and gynecologic examination; PoP-Q staging; CST; post-voidal residue evaluation; q-tip test; urodynamic testing; ICIQ-SF, I-QOL, King’s Health, PISQ-12, and PGI-S questionnaires. Women were randomly divided into two group to undergo TVT-O or TVT-Abbrevo, respectively. During the procedure type of anesthesia, time of the procedure, intraoperative bleedin, and intraoperative complication were recorded. Pain VAS score possible pain) (12 and 24 hours after the procedure), antalgic drugs, delta Hb and post-operative complications. Follow-up visits were performed 1, 3, 6 and 12 months after the procedure. The following parameters were evaluated: general and gynecologic examination (with PoP-Q); CST; post-voidal residue; urodynamics; questionnaires; complications. Chi square test was used to evaluate cure rates. Results: Six women were lost at follow-up (2 in the TVT-O group and 4 in the TVT-Abbrevo group), leaving a total of 37 patients in the TVT-O group and 35 in the TVT-Abbrevo group. Thirty-four (91.9%) in the TVT-O group and thirty (85.7%) in the TVT-Abbrevo group satisfied the definition of cure (p = NS). Complication rates were similar in the two groups. Pain VAS score was significantly lower in the TVT-Abbrevo group, both at 12 and 24 hours (5.6±2.3 vs.
2.1±1.0 at 12 hours and 2.8±1.5 vs. 1.1±0.5 at 24 hours). Persistent groin pain was observed in two patients in the TVT-O group three months after the procedure, but spontaneously disappeared at 12 months evaluation. Conclusions: Both devices seem to be effective and safe for the surgical management of SUI. TVT-Abbrevo is associated with less post-operative pain. O693 THE EPIDEMIOLOGIC INVESTIGATION AND CLINICAL CHARACTERISTICS OF CERVICAL CANCER IN BEIJING OVER THE PAST 16 YEARS W. Tong1 . 1 Gynecology oncology, Obstetrics & Gynecology Hospital Affiliated to Capital Medical University, Beijing, China Objectives: To explore the epidemiological characteristics of cervical cancer in Beijing in the past 16 years and investigate the situation of diagnosis and treatment in the different scale levels of hospitals. Materials: Using stratified cluster sampling, we chose 33 different rank hospitals in Beijing. A retrospective review of all invasive cervical cancer cases newly diagnosed in these hospitals from 1993 to 2008 was performed. Methods: The calculation were performed using the statistic package for the social sciences (SPSS 15.0). All test were two sided and P values of less than 0.05 were considered statistically significant. Results: A total of 2209 cases were analyzed. (1) Average 52.6 women were diagnosed invasive cervical cancer every year in all 33 hospitals from 1993 to 2000, while the number increased to 223.5 from 2001 to 2008. (2) Median age of diagnosis was 51.5 years (ranging from 17 to 88). Median age gradually decreased from 58.8 years(group 1993–2000) to 49.6 years(group 2001–2008) (P < 0.05). (3) Prevalence in populations of occupation distribution occupy the top three is unemployed and retired persons (27%), workers (17.4%), and farmers (12.9%). (4) In 2176 cases having related records, only 18% women were found cervical cancer by routine gynecological examination without any symptoms before 2000, the percentage was 17.4% after 2001 (P > 0.05). (5) 45.6% cases have not undergone vagino-recto-abdominal examination in suburban hospitals; the proportion is 26.1% in large A-level general hospitals and 9.8% in A-level gynecologic oncology hospitals respectively (P < 0.05). (6) 125 (5.7%) cases have no staging. The proportion of patients with stage I and IIa also increased from 23.7% (group 1993–2000) to 58.4% (group 2001–2008) (P < 0.05). Conclusions: Over the past 2 decades, the number of newly diagnosed cervical cancer cases showed an increased trend in Beijing. The proportion of young patients and patients with early staging have both increased. The unemployed and little income crowd has poor medical security and lack consciousness and conditions of regular screening. Pretreatment diagnostic assessment was undergone more comprehensively and normally in A-level gynecologic oncology hospitals. Overall people don’t pay much attention to regular screening. We should raise public awareness of the screening, standardize diagnosis and therapy. O694 SHOULD 2D OR 3D ULTRASOUND BE PREFERRED IN LABOR? ˚ Salvesen2,3 , T.M. Eggebø1 . 1 Department of E.A. Torkildsen1 , K.A. Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway; 2 Department of Laboratory Medicine, Women’s and Children’s Health, Norwegian University of Science and Technology, Trondheim, Norway; 3 Department of Obstetrics and Gynecology, Clinical Sciences, Lund University, Lund, Sweden Objectives: Fetal head position and descent in labor can be assessed objectively using ultrasound. 3D software assessing angle of progression, progression distance, head direction and midline is available. The 3D methods are complicated and acquisitions must
Free communication (oral) presentations / International Journal of Gynecology & Obstetrics 119S3 (2012) S261–S530
Questionnaire (KHQ) and a urinary diary were performed before and 12 months after procedure. Results: 25 patients (10 for TVT-O and 13 for TVT-Secur) were lost at follow-up, leaving a total of 80 patients for TVT-O and 77 for TVT-Secur. Duration of the procedure was significantly lower in the TVT-Secur group (7.8±1.1 minutes vs. 12.8±2.4 minutes; p < 0.05). Blood loss was not different, even though patients from the TVTSecur group tended to have higher percentage of moderate blood loss. A case of severe blood loss was observed in the TVT-Secur group, even though transient. Time to first voiding was significantly higher in the TVT-O group in comparison with TVT-Secur group (90.4±33.5 min. vs. 61.2±1.9 min.; p < 0.05). Objective cure were 86.2% for TVT-O and 80.5% for TVT-Secur (p NS). No intra-operative complications were observed in the two groups. The most frequent post-operative complications was transient leg pain (3 cases; 3.7%) for TVT-O and de novo urgency (5 cases; 6.5%) for TVT-Secur. Two cases of vaginal erosion by the tape was observed in the TVT-Secur group and one in the TVT-O. Post-operative pain VAS scoring was significantly lower in the TVT-Secur group in comparison with the TVT-O group (p < 0.05). Conclusions: Both techniques appear to be safe and effective. TVTSecur shortened operative time and reduced bladder obstruction and thigh pain, but has higher de novo urgency rates. There seems not to be a significant decline in efficacy three years after the procedure in both groups. O692 COMPARISON OF TVT-O AND TVT-ABBREVO FOR THE SURGICAL MANAGEMENT OF FEMALE STRESS URINARY INCONTINENCE: A 12-MONTHS PRELIMINARY STUDY G.A. Tommaselli1 , A. D’Afiero2 , C. Formisano1 , A. Fabozzi1 , C. Di Carlo1 , C. Nappi1 . 1 Obstetrics and Gynecology, University of Naples ‘Federico II’, Naples, Italy; 2 Ospedale S. Maria della Piet` a, Casoria, Italy Objectives: To compare TVT-O (Ethicon Women’s Health and Urology) with a modified device with the same trajectory, but with a reduced length (TVT-Abbrevo, Ethicon Women’s Health and Urology). Materials: Seventy-eight women were enrolled for this prospective study. Inclusion criteria were stress urinary incontinence (SUI) diagnosed at challenge stress test (CST) with urethral hypermobility, and at urodynamics; sign of the informed consent to randomization, surgical procedure and choosen type of anesthesia. Exclusion criteria were isolated or predominant urge incontinence; genital prolapse >2 stage according PoP-Q; severe contraindications to surgical procedures; incapacity of giving informed consent to randomization, surgical procedure and choosen type of anesthesia. Methods: Patients preoperatively underwent general and gynecologic examination; PoP-Q staging; CST; post-voidal residue evaluation; q-tip test; urodynamic testing; ICIQ-SF, I-QOL, King’s Health, PISQ-12, and PGI-S questionnaires. Women were randomly divided into two group to undergo TVT-O or TVT-Abbrevo, respectively. During the procedure type of anesthesia, time of the procedure, intraoperative bleedin, and intraoperative complication were recorded. Pain VAS score possible pain) (12 and 24 hours after the procedure), antalgic drugs, delta Hb and post-operative complications. Follow-up visits were performed 1, 3, 6 and 12 months after the procedure. The following parameters were evaluated: general and gynecologic examination (with PoP-Q); CST; post-voidal residue; urodynamics; questionnaires; complications. Chi square test was used to evaluate cure rates. Results: Six women were lost at follow-up (2 in the TVT-O group and 4 in the TVT-Abbrevo group), leaving a total of 37 patients in the TVT-O group and 35 in the TVT-Abbrevo group. Thirty-four (91.9%) in the TVT-O group and thirty (85.7%) in the TVT-Abbrevo group satisfied the definition of cure (p = NS). Complication rates were similar in the two groups. Pain VAS score was significantly lower in the TVT-Abbrevo group, both at 12 and 24 hours (5.6±2.3 vs.
2.1±1.0 at 12 hours and 2.8±1.5 vs. 1.1±0.5 at 24 hours). Persistent groin pain was observed in two patients in the TVT-O group three months after the procedure, but spontaneously disappeared at 12 months evaluation. Conclusions: Both devices seem to be effective and safe for the surgical management of SUI. TVT-Abbrevo is associated with less post-operative pain. O693 THE EPIDEMIOLOGIC INVESTIGATION AND CLINICAL CHARACTERISTICS OF CERVICAL CANCER IN BEIJING OVER THE PAST 16 YEARS W. Tong1 . 1 Gynecology oncology, Obstetrics & Gynecology Hospital Affiliated to Capital Medical University, Beijing, China Objectives: To explore the epidemiological characteristics of cervical cancer in Beijing in the past 16 years and investigate the situation of diagnosis and treatment in the different scale levels of hospitals. Materials: Using stratified cluster sampling, we chose 33 different rank hospitals in Beijing. A retrospective review of all invasive cervical cancer cases newly diagnosed in these hospitals from 1993 to 2008 was performed. Methods: The calculation were performed using the statistic package for the social sciences (SPSS 15.0). All test were two sided and P values of less than 0.05 were considered statistically significant. Results: A total of 2209 cases were analyzed. (1) Average 52.6 women were diagnosed invasive cervical cancer every year in all 33 hospitals from 1993 to 2000, while the number increased to 223.5 from 2001 to 2008. (2) Median age of diagnosis was 51.5 years (ranging from 17 to 88). Median age gradually decreased from 58.8 years(group 1993–2000) to 49.6 years(group 2001–2008) (P < 0.05). (3) Prevalence in populations of occupation distribution occupy the top three is unemployed and retired persons (27%), workers (17.4%), and farmers (12.9%). (4) In 2176 cases having related records, only 18% women were found cervical cancer by routine gynecological examination without any symptoms before 2000, the percentage was 17.4% after 2001 (P > 0.05). (5) 45.6% cases have not undergone vagino-recto-abdominal examination in suburban hospitals; the proportion is 26.1% in large A-level general hospitals and 9.8% in A-level gynecologic oncology hospitals respectively (P < 0.05). (6) 125 (5.7%) cases have no staging. The proportion of patients with stage I and IIa also increased from 23.7% (group 1993–2000) to 58.4% (group 2001–2008) (P < 0.05). Conclusions: Over the past 2 decades, the number of newly diagnosed cervical cancer cases showed an increased trend in Beijing. The proportion of young patients and patients with early staging have both increased. The unemployed and little income crowd has poor medical security and lack consciousness and conditions of regular screening. Pretreatment diagnostic assessment was undergone more comprehensively and normally in A-level gynecologic oncology hospitals. Overall people don’t pay much attention to regular screening. We should raise public awareness of the screening, standardize diagnosis and therapy. O694 SHOULD 2D OR 3D ULTRASOUND BE PREFERRED IN LABOR? ˚ Salvesen2,3 , T.M. Eggebø1 . 1 Department of E.A. Torkildsen1 , K.A. Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway; 2 Department of Laboratory Medicine, Women’s and Children’s Health, Norwegian University of Science and Technology, Trondheim, Norway; 3 Department of Obstetrics and Gynecology, Clinical Sciences, Lund University, Lund, Sweden Objectives: Fetal head position and descent in labor can be assessed objectively using ultrasound. 3D software assessing angle of progression, progression distance, head direction and midline is available. The 3D methods are complicated and acquisitions must