The Role of Transobturator Tape (TOT) Operation in the Treatment of Pelvic Organ Prolapse and Stress Urinary Incontinence

Abstract

Aim: This study aimed to assess the efficacy and safety of the Transobturator Tape (TOT) procedure in treating stress urinary incontinence (SUI), both independently and when combined with pelvic floor reconstruction surgery. Method: In a retrospective analysis, data were collected from 251 female patients treated for SUI at Health Sciences University, İstanbul Bağcılar Training and Research Hospital, from April 2020 to April 2022. Patients were divided into two groups based on the surgical approach: TOT alone and TOT with pelvic reconstruction. The Patient Global Impression of Improvement (PGI-I) scale was used to evaluate patient-reported outcomes, measuring improvements in symptoms and quality of life post-surgery. Results: The results demonstrated a high success rate in SUI management, with a significant percentage of patients reporting the absence of incontinence after surgery. Notably, cases with TOT alone showed slightly higher success rates and patient satisfaction compared to those combined with pelvic reconstruction. The outcomes aligned with existing research, supporting TOT as an effective intervention in diverse surgical settings. Conclusion: TOT is a highly effective treatment for SUI, with its use either alone or in combination with pelvic reconstruction. The study emphasizes the importance of individualized surgical approaches based on patient-specific characteristics, highlighting the need for thorough preoperative assessments and patient counseling to optimize outcomes.

Keywords

• Transobturator tape
• stress urinary incontinence
• pelvic floor reconstruction

Transobturator Bant (TOT) Operasyonunun Pelvik Organ Prolapsusu ve Stres Üriner İnkontinans Tedavisindeki Rolü

Abstract

Amaç: Bu çalışmanın amacı, stres üriner inkontinansın (SÜİ) tedavisinde transobturator bant (TOT) yönteminin, tek başına veya pelvik taban rekonstrüksiyon cerrahisiyle birlikte kullanıldığında etkinliğini ve güvenliğini değerlendirmektir. Yöntem: Retrospektif olarak gerçekleştirilen bu çalışmada, Nisan 2020 - Nisan 2022 tarihleri arasında Sağlık Bilimleri Üniversitesi, İstanbul Bağcılar Eğitim ve Araştırma Hastanesi’nde SÜİ tedavisi gören 251 kadın hastanın verileri incelendi. Hastalar, TOT tek başına uygulananlar ve TOT ile pelvik rekonstrüksiyon yapılanlar olmak üzere iki gruba ayrıldı. Hasta Küresel İyileşme İzlenimi (PGI-I) ölçeği ile cerrahi sonrası semptomlar ve yaşam kalitesindeki iyileşmeler değerlendirildi. Bulgular: Sonuçlar, SÜİ yönetiminde yüksek bir başarı oranı göstermiş olup, cerrahi sonrası önemli bir hasta grubunda inkontinansın sona erdiği bildirilmiştir. Sadece TOT uygulanan hastalarda, pelvik rekonstrüksiyon eklenen vakalara kıyasla başarı oranı ve hasta memnuniyeti biraz daha yüksek bulunmuştur. Sonuçlar, mevcut literatürle uyumlu olarak TOT yönteminin çeşitli cerrahi bağlamlarda etkili bir müdahale olduğunu desteklemektedir. Sonuç: TOT yöntemi, SÜİ için son derece etkili bir tedavi olup gerek tek başına gerekse pelvik rekonstrüksiyon ile birlikte kullanılabilir. Çalışma, hasta özelliklerine göre bireyselleştirilmiş cerrahi yaklaşımların önemini vurgulayarak, başarılı sonuçlar için ayrıntılı preoperatif değerlendirme ve hasta bilgilendirmesinin gerekliliğine dikkat çekmektedir.

Keywords

• Transobturator bant
• stres üriner inkontinans
• pelvik taban rekonstrüksiyonu

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