Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Apr 22;12(2):35.
doi: 10.21037/atm-23-1876. Epub 2024 Apr 18.

Tension-free artisan tape: a low-cost option for cure of pelvic organ prolapse and stress incontinence

Ahmet Akin Sivaslioglu  1 , Ion-Andrei Muller-Funogea  2 , Paolo Palma  3
Affiliations
Review

Tension-free artisan tape: a low-cost option for cure of pelvic organ prolapse and stress incontinence

Ahmet Akin Sivaslioglu et al. Ann Transl Med. .

Abstract

The Lancet PROSPECT Trial has shown that vaginal repair has dismal cure rates of some 20% at 12 months. Meanwhile 10-year data from collagen creating ligament repair methods (implanted mini-sling tapes), with no vaginal excision, report very high, long-term cure rates. The reason for conserving the vagina, is that the vagina's main function is to transmit the muscle forces for external urethral closure or opening. Ligaments provide the main structural support for the organs, much like a suspension bridge. Collagen is the key structural component of the ligaments which structurally support the organs. However, collagen breaks down after the menopause and is excreted as hydroxyproline. If sufficient collagen breaks down, the ligaments weaken, and this explains the 80% failure rates for native ligament in the Lancet PROSPECT Trial. Whereas satisfactory results for pelvic organ prolapse (POP) and symptoms have been obtained with native ligament repair in premenopausal women, it has been shown that collagen-creating ligament repair method, for example, precisely inserted tapes, is required in older women. Tension-free" artisan tapes work in the same way as commercial tape kits which have been used to cure stress urinary incontinence (SUI) and POP. The "tension-free" artisan tape results for POP at three years were encouraging, but were applied only in a small number of cases. Very recently, long-term (5.7 years) tension-free artisan tape data has become available from artisan SUI surgery. Results from 93 women using an artisan transobturator tape (TOT) achieved a cure rate of 91.3% at a mean of 5.7 years postoperatively. The only significant complication was a 4.3% erosion rate. The implications are that tension-free artisan tape for POP is also likely to be long-lasting. Another implication is the cost, which, for each tape, is a few Euros. The low cost allows the artisan method to be applied even in the poorest nations.

Keywords: Artisan tape; collagen; neoligament; prolapse; stress urinary incontinence (SUI).

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://atm.amegroups.com/article/view/10.21037/atm-23-1876/coif). The series “Integral Theory Paradigm” was commissioned by the International Society for Pelviperineology without any funding or sponsorship. The authors have no other conflicts of interest to declare.

Figures

Video S1
Video S1
Video abstract of structure, collagen, and pathogenesis surgery.
Video S2
Video S2
Video abstract of artisan tape 12-month data.
Video S3
Video S3
Artisan tape surgical technique. Source: Piñango-Luna (4).
Video S4
Video S4
Repair of the suburethral vaginal hammock after midurethral tape placement. Source: Piñango-Luna (4).
See this image and copyright information in PMC

References

    1. Glazener CM, Breeman S, Elders A, et al. Mesh, graft, or standard repair for women having primary transvaginal anterior or posterior compartment prolapse surgery: two parallel-group, multicentre, randomised, controlled trials (PROSPECT). Lancet 2017;389:381-92. - PubMed
    1. Shkarupa D, Zaytseva A, Kubin N, et al. Native tissue repair of cardinal/uterosacral ligaments cures overactive bladder and prolapse, but only in pre-menopausal women. Cent European J Urol 2021;74:372-8. 10.5173/ceju.2021.285.3 - DOI - PMC - PubMed
    1. Inoue H, Kohata Y, Fukuda T, et al. Repair of damaged ligaments with tissue fixation system minisling is sufficient to cure major prolapse in all three compartments: 5-year data. J Obstet Gynaecol Res 2017;43:1570-7. 10.1111/jog.13413 - DOI - PubMed
    1. Piñango-Luna S, Level-Córdova L, Petros PE, et al. A low cost artisan tension-free tape technique cures pelvic organ prolapse and stress urinary incontinence - proof of concept. Cent European J Urol 2020;73:490-7. 10.5173/ceju.0202.R1 - DOI - PMC - PubMed
    1. Yamada H. Aging rate for the strength of human organs and tissues. In: Yamada H, Evans FG, editor. Strength of biological materials. Baltimore, MD: Williams & Wilkins; 1970:272-80.

LinkOut - more resources