The short-term efficacy of trans-obturator tape procedure and its effect on the quality of life in women with stress urinary incontinence

Abstract

Objectives: Demonstrating the efficacy of trans-obturator tape (TOT) procedure for treatment of stress urinary incontinence (SUI) and its effects on patient’s quality of life. Materials and Methods: We analyzed the data of 108 patients (63 SUI;45 MUI) who underwent the TOT procedure between January 2006 and January 2009. Preoperative and postoperative evaluations included physical examination, Q-tip test, stress test, pad use, bladder capacity, PVR, POP-Q score and QoL questionnaires (IIQ-7 and UDI-6). Three different tapes were used and two different approaches (68 outside-in, 40 inside-out) were performed. Results: Patients were between 30 and 81 years old. One-year minimum follow-up (median, 22 months) was available for all patients. Postoperative Q-tip test results, pad use, number of voiding during the day and night, and QoL-Q scores were significantly lower (p<0.01). There was no significant difference in between groups regarding device or approach related complications (p>0.05). The device type, the technique performed, BMI, concomitant surgery did not significantly affect the success rates (p>0.05). The overall success rate of the TOT procedure was 87.9% after one year. Conclusion: TOT is an easy procedure with compatible effectiveness in short and medium term relative to other treatments in the literature, and could substantially eliminate the great vessel, bladder, and bowel injuries. It seems to be effective for both SUI and MUI patients, and could be useful at obese cases, as well. Both trans-obturator access routes are equally safe. Concomitant pelvic surgery does not seem to have an impact on success rates.