A study of transobturator tape in stress urinary incontinence

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Abstract

Background:

Stress urinary incontinence (SUI) is commonly encountered in gynecological practice. Nowadays, midurethral sling surgeries in the form of transobturator tape (TOT) surgery are recommended in its treatment.

Aims and Objectives:

To assess the outcome and patient satisfaction of TOT surgery in the treatment of SUI.

Materials and Methods:

A prospective study was undertaken for patients of SUI who underwent TOT surgery by the outside in method and followed up for 5 years. The patients were assessed clinically and by the Patient Global Impression of Improvement (PGI-I) preoperatively and at postoperative day 3, discharge and 3 months follow-up.

Results:

Successful surgical treatment with TOT was seen in all patients at the time of discharge. There was no recurrence of SUI seen up to 1 year, but at 5-year follow-up two patients had a recurrence of SUI on examination though they did not complain of SUI. Urinary retention, tape extrusion, and groin stitch infection were the commonly seen complications following surgery. On subjective assessment, 61 patients were completely satisfied at day 3, and all patients were completely satisfied at discharge and 3 months follow-up as per the PGI-I score.

Conclusion:

TOT gives an excellent outcome in the treatment of SUI.

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Most cited references 27

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Validation of two global impression questionnaires for incontinence.

Ilker Yalcin, Richard C. Bump (2003)

The purpose of this study was to assess the construct validity of two global assessment questions, the Patient Global Impression of Severity and of Improvement, in female patients with stress urinary incontinence. This was a secondary analysis of data from two double-blind, placebo-controlled studies that evaluated duloxetine for the treatment of predominant stress urinary incontinence in the United States (n = 1133 patients). Assessment variables included incontinence episode frequency, the Incontinence Quality of Life Questionnaire results, fixed volume (400 mL) stress pad test results, and the Patient Global Impression of Improvement and of Severity question results. Spearman correlation coefficients were 0.36, 0.20, and -0.50 among the Patient Global Impression of Severity question and incontinence episode frequency, stress pad test, and Incontinence Quality of Life Questionnaire results, respectively (all P <.0001). Mean incontinence episode frequency and median stress pad test results increased and mean Incontinence Quality of Life Questionnaire results decreased with increasing Patient Global Impression of Severity question severity levels. Similarly, significant (P <.0001) correlations were observed between the Patient Global Impression of Improvement question response categories and the three independent measures of improvement in stress urinary incontinence (0.49, 0.33, and -0.43 with incontinence episode frequency, stress pad test, and Incontinence Quality of Life Questionnaire results, respectively). As with the Patient Global Impression of Severity question, differences in mean changes for Incontinence Quality of Life Questionnaire and median percent changes for incontinence episode frequency and stress pad test among the Patient Global Impression of Improvement question response categories were highly significant (P <.0001). These relationships indicate appropriate and significant associations between the Patient Global Impression of Severity and of Improvement questions and the three independent measures of stress urinary incontinence severity and improvement, respectively. The Patient Global Impression of Severity and of Improvement question responses were correlated significantly with incontinence episode frequency, stress pad test, and Incontinence Quality of Life Questionnaire measures, which established the construct validity of these two global assessment questions for baseline severity and treatment response, respectively.

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Mid-urethral sling operations for stress urinary incontinence in women.

Abigail A Ford, Lynne Rogerson, June D Cody … (2015)

Urinary incontinence is a very common and debilitating problem affecting about 50% of women at some point in their lives. Stress urinary incontinence (SUI) is a contributory or predominant cause in 30% to 80% of these women. Mid-urethral sling (MUS) operations are a recognised minimally invasive surgical treatment for SUI. MUS involves the passage of a small strip of tape through either the retropubic or obturator space, with entry or exit points at the lower abdomen or groin, respectively. This review does not include single incision slings.

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Presentation and management of major complications of midurethral slings: Are complications under-reported?

Larissa Rodriguez, Y-l Deng, Shlomo Raz … (2006)

Midurethral slings have become the mainstay of stress urinary incontinence (SUI) treatment due to their efficacy and low complication rates. The purpose of this study was to report the presentation and treatment of major complications from these minimally invasive treatments presented to a tertiary referral practice and to highlight a discrepancy in major complications between literature and the food and drug administration (FDA) device failure database. From 2001 through 2005, we reviewed all cases of midurethral sling complications that presented to our institution. A literature review of all complications due to midurethral slings during the same time period was performed as was the FDA manufacturer and user facility device experience (MAUDE) database queried for self-reported complications. A total of 26 patients referred to UCLA with voiding dysfunction after sling placement was found to have mesh in the urethra or bladder. Treatments required a combination of urethrolysis with mesh removal, urethral reconstruction with graft, and bladder excision. These were compared to major complications reported in the world literature of <1%. The MAUDE database contained 161 major complications out of a total of 928 complications reported for suburethral slings. There was significantly more major complications reported in MAUDE than in published literature. Although rare, major complications of midurethral slings are more common than appear in literature. Devastating complications involving urethral and bladder perforations can present with mild urinary symptoms and thus are likely under-diagnosed and under-reported. Most of these cases need to be managed with additional reconstructive surgery. Copyright 2006 Wiley-Liss, Inc.

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Author and article information

Journal

Journal ID (nlm-ta): Urol Ann

Journal ID (iso-abbrev): Urol Ann

Journal ID (publisher-id): UA

Title: Urology Annals

Publisher: Medknow Publications & Media Pvt Ltd (India )

ISSN (Print): 0974-7796

ISSN (Electronic): 0974-7834

Publication date (Print): Jan-Mar 2017

Volume: 9

Issue: 1

Pages: 9-12

Affiliations

[1]Department of Obstetrics and Gynaecology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India

Author notes

Address for correspondence: Dr. Rahul Vishwanath Mayekar, Department of Obstetrics and Gynaecology, Lokmanya Tilak Municipal Medical College and General Hospital, Room No. 131 College Building, Sion, Mumbai - 400 022, Maharashtra, India. E-mail: rvmayekar@ 123456gmail.com

Article

Publisher ID: UA-9-9

DOI: 10.4103/0974-7796.198867

PMC ID: 5308050

SO-VID: 645ea7d7-603b-479c-a08c-963102513dd1

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This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

A study of transobturator tape in stress urinary incontinence

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Abstract

Background:

Aims and Objectives:

Materials and Methods:

Results:

Conclusion:

Related collections

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Most cited references 27

Validation of two global impression questionnaires for incontinence.

Mid-urethral sling operations for stress urinary incontinence in women.

Presentation and management of major complications of midurethral slings: Are complications under-reported?

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