Long-Term Surgical Outcomes of Transobturator Tape Procedure in Women With Mixed Urinary Incontinence
Abstract
Objective: To evaluate postoperative outcomes and complications of transobturator tape (TOT) procedure in the treatment of patients with mixed urinary incontinence (MUI).
Materials and methods: We analyzed 193 consecutive female patients who underwent TOT procedure. Among these patients 75 women with MUI were the subjects of this study. All patients were evaluated with the International Consultation on Incontinence Questionnaire-Short form (ICIQ-SF) preoperatively and at the postoperative follow-up visits. Patient satisfaction was evaluated with Visual analog scale. On the postoperative 15th day, all patients were routinely evaluated with urine culture and possible early postoperative complications were examined. Patients were evaluated on the postoperative 3rd, 12th months and annually with pelvic examination, VAS, cough stress test (CST) and ICIQ-SF. Surgical outcomes were evaluated and data of subjective and objective cure rates, any complications related to the procedure were registered. Statistical analyses were performed with SPSS 17.0 (SPSS version 17.0, Chicago, IL, USA).
Results: A total of 67 women who met the requirements for inclusion and who had available records for analysis were included in the study. Objective cure, subjective cure and patient satisfaction rates were 89.6, 53.7 and 70.1% respectively. The mean score for 29 patients with a postoperative 5th year ICIQ-SF score >0 was 12.2 (SD ± 4.2). Of the 67 patients, the urgency urinary incontinence (UUI) component of 12 patients (17.9%) had improved postoperatively. Fifty-five (82%) patients with persistent UUI postoperatively were treated with antimuscarinic drugs. None of our patients experienced intraoperative complications. Two (3%)
patients required re-operation for recurrent stress urinary incontinence (SUI) in the follow-up. Conclusion: TOT procedure is successful for surgical treatment of MUI with predominant SUI in long-term follow-up. The operation was satisfactory for the most of the women. Persistence of UUI was the main reason for dissatisfaction
Keywords
TOT, mixed urinary incontinence, stress urinary incontinence
References
- 1. Jain P, Jirschele K, Botrus SM, Latthe PM. Effectiveness of midurethral slings in mixed urinary incontinence: a systematic review and meta-analysis. Int Urogynecol J 2011; 22: 923-932.
- 2. Hannestad YS, Rortveit G, Sandvik H, et al. A community-based epidemiological survey of female incontinence: the Norwegian EPINCONT study. Epidemiology of Incontinence County of Nord-Trondelag. J Clin Epidemiol 2000; 53: 1150-1157.
- 3. Porena M, Costantini E, Lazzeri M. Mixed Incontinence: How best to manage it? Curr Bladder Dysfunct Rep 2013; 8: 7-12.
- 4. Irwin DE, Milsom I, Chancellor MB, et al. Dynamic progression of overactive bladder and urinary incontinence symptoms: a systematic review. Eur Urol 2010; 58: 532-543.
- 5. Richter HE, Albo ME, Zyczynski HM, et al. Retropubic versus transobturator midurethral slings for stres incontinence. N Engl J Med 2010; 362: 2066-2076.
- 6. Latthe PM, Foon R, Toozs-Hobson P. Transobturator and retropubic tape procedures in stress urinary incontinence: a systematic review and meta-analysis of effectiveness and complications. BJOG 2007; 114: 522- 531.
- 7. Novara G, Artibani W, Barber MD, et al. Updated systematic review and metaanalysis of the comperative data on colposuspensions, pubovaginal slings and midurethral tapes in the surgical treatment of female stres urinary incontinence. Eur Urol 2010; 58: 218- 238.
- 8. Delorme E. Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women. Prog Urol. 2001;11:1306–1313.
- 9. Abdel-fattah M, Mostafa A, Young D, et al. Evaluation of transobturator tensionfree vaginal tape in the management of women with mixed urinary incontinence: one-year outcomes. Am J Obstet Gynecol 2011; 205: 150.e1-6.
- 10. Nyyssönen V, Talvensaari-Mattila A, Sanatala M. A prospective randomized trial comparing tension-free vaginal tape versus transobturator tape in patients with stress or mixed urinary incontinence: subjective cure rate and satisfaction in median follow-up of 46 months. Scandinavian J Urol 2014; 48: 309-315.