Effect of Transobturator Midurethral Sling Placement on Urgency and Urge Incontinence

Habibi, Joseph; Petrossian, Albert; Rapp, David E.

doi:10.1097/spv.0000000000000181

Cited by 6 publications

(6 citation statements)

References 20 publications

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“…Other investigators have reported similar findings (28,29). Theoretically, reconstitution of the pubourethral ligament may lead to improved urethral coaptation (by stabilizing the posterior urethra) and more effective urge suppression.…”

Section: Discussionsupporting

confidence: 82%

Burch Retropubic Urethropexy Compared With Midurethral Sling With Concurrent Sacrocolpopexy

Trabuco

Klingele

Blandon

et al. 2016

Obstetrics &Amp; Gynecology

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Objective To compare efficacy and safety of retropubic Burch urethropexy and midurethral sling in women with SUI undergoing concomitant pelvic floor repair with sacrocolpopexy. Methods Women were randomly assigned to Burch retropubic urethropexy (n=56) or retropubic midurethral sling (n=57) through dynamic allocation balancing age, body mass index, history of prior incontinence surgery, intrinsic sphincter deficiency, preoperative incontinence diagnosis, and prolapse stage. Overall and stress-specific continence primary outcomes were ascertained with validated questionnaires and blinded cough stress test. Results Enrollment was June 1, 2009, through August 31, 2013. At 6 months, no difference was found in overall (29 midurethral sling [51%] vs 23 Burch [41%]; P=.30) (odds ratio [OR] [95% CI], 1.49 [0.71–3.13]) or stress-specific continence rates (42 midurethral sling [74%] vs 32 Burch [57%]; P=.06) (OR [95% CI], 2.10 [0.95–4.64]) between groups. However, the midurethral sling group reported greater satisfaction (78% vs 57%; P=.04) and were more likely to report successful surgery for SUI (71% vs 50%; P=.04), and to resolve preexisting urgency incontinence (72% vs 41%; P=.03). No difference was found in patient global impression of severity or symptom improvement, complication rates, or mesh exposures. Conclusion There was no difference in overall or stress-specific continence rates between midurethral sling and Burch urethropexy groups at 6 months. However, the midurethral sling group reported better patient-centered secondary outcomes.

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Section: Discussionsupporting

confidence: 82%

Burch Retropubic Urethropexy Compared With Midurethral Sling With Concurrent Sacrocolpopexy

Trabuco

Klingele

Blandon

et al. 2016

Obstetrics &Amp; Gynecology

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“…Costantini et al (31), comparing TO-TVT with RP-TVT in an RCT, determined that 31 women (66%) in the TOT group had baseline MUI and showed a patient-reported success rate of 77.4% at year 3. Habibi et al (30) also reported that patients who were cured of MUI after having incontinence surgery had higher satisfaction rates compared to those with persistent UUI. In our study, the overall satisfaction rate was significantly higher compared to those with persistent UUI at the first-and third-year follow-up (90% versus 56%, p <0.001 at year 1; 82% versus 32%, p <0.001 at year three).…”

Section: Discussionmentioning

confidence: 98%

“…Only limited studies have assessed QoL after TOT placement. Habibi et al (30) found that the beneficial effects of TVT-O placement on QoL persisted at 12 months and that the QoL measurements were correlated with urgency outcomes. In another study which evaluated the long-term effects of TOT and TVT-O on QoL, 85-87% of patients reported significant improvements in QoL (9,24).…”

Section: Discussionmentioning

confidence: 99%

“…Our postoperative patient satisfaction rates were consistent with the literature. Habibi et al (30) assessed the effects of TVT-O procedures on MUI and reported that 87% of their patients were satisfied at 12 months. Costantini et al (31), comparing TO-TVT with RP-TVT in an RCT, determined that 31 women (66%) in the TOT group had baseline MUI and showed a patient-reported success rate of 77.4% at year 3.…”

Section: Discussionmentioning

confidence: 99%

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Effects of the transobturator tape procedure on overactive bladder symptoms and quality of life: a prospective study

et al. 2019

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Introduction: This study aimed to evaluate the effects of transobturator tape (TOT) on overactive bladder (OAB) symptoms and quality of life. Materials and Methods: Patients with stress-predominant mixed urinary incontinence (MUI) who had undergone TOT procedures were considered candidates for this research. Preoperative assessment included anamnesis, pelvic examination, cough stress test (CST), and validated symptom severity and quality of life (QoL) questionnaires. The primary outcome, improvement and cure rates of OAB symptoms were determined based on the patient's baseline scores in symptom-related questions in OAB-V8. Secondary outcomes included the success rates of SUI, changes in the QoL score and patient satisfaction rates. Results: A total of 104 patients were included in the study. Sixty-two patients underwent TOT placement alone, and 42 patients underwent TOT placement along with prolapse surgery. The mean follow-up period of the patients was 30.47 months range: 13-52 months. At the fi rst-year follow-up, 52 patients (50.0%) and 59 patients (56.7%) reported cure in preoperative urgency and urgency incontinence, respectively. The objective and subjective cure rates were 96.2% and 56.7%, respectively. A total of 80.7% of the cases had a 15-point improvement in QoL scores. Conclusions: MUS is not only a gold standard treatment in SUI but also presents as a promising treatment modality in stress-dominant MUI. Although the improvement rates of OAB symptoms signifi cantly decrease over time, QoL and patient satisfaction rates remain higher than any other treatment in this patient group at the third-year follow-up.

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“…Studies that assess functional recovery after implantation of a transobturator suburethral tape are limited [4,16]. Additionally, different questionnaires are often used, making it difficult to compare the results.…”

Section: Introductionmentioning

confidence: 99%

The American Society of Anesthesiologists Physical Status (ASA-PS) Risk Group Classification Can Be Used to Anticipate Functional Recovery Outcomes after the Surgical Treatment of Female Urinary Incontinence with Transobturator Suburethral Tape

Cisneros-Pérez

Yusta-Martín

Sánchez-Conde

et al. 2020

JCM

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Introduction: Stress urinary incontinence (SUI) has an incidence of 15–80% in women. One of the most widely used surgical techniques for treatment is the placement of a suburethral transobturator tape (TOT). Although this technique has a relatively low morbidity rate, it is not exempt from intraoperative or postoperative complications, which can have an impact on functional recovery, understood as the return to routine life prior to the intervention. Aims: To assess the time for functional recovery in women operated on for SUI by TOT; to identify complications and related factors, according to anaesthetic risk, which condition the time to functional recovery; and proposals for improvements in the prevention of possible complications and in reducing functional recovery time. Materials and methods: A non-concurrent prospective observational multicenter study of 891 women undergoing TOT for stress urinary incontinence since 1 April 2003, who were successful in achieving urinary continence (completely dry). Study groups: GA (n = 443): patients with ASA I risk. GB (n = 306): patients with ASA II risk. GC (n = 142): patients with anaesthetic risk ASA III. Investigated variables: age, body mass index, follow-up time, secondary diagnoses, surgical history, obstetric-gynecological history, toxic habits, and complications derived from surgery: bleeding, pain, infection. Descriptive statistics, Student’s t test, Chi2, Fisher, ANOVA, multivariate analysis, significance for p < 0.05. Results: Mean age was 60.10 years (SD13.38), with no difference between groups. Mean body mass index (BMI) was 26.55 kg/m2 (SD 4.51), lowest in GA. GB had more HT (38.6%) than GC (23.23%), more type 2 diabetes (19.83% versus 10.56%), and more respiratory disorders (6.97% versus 2.11%). There were more women with anxiety in GB (19.3%) than in GC (6.33%) (p = 0.0221) and GA (10.51%) (p = 0.0004). There was more hypothyroidism in GB (16.08%) compared to GC (2.11%) and GA (9.07%). There was more history of curettage in GC (11.97%) versus GB (5.63%); and more pelvic surgery in GB (71.31%) and GC (66.9%) compared to GA (32.57%). There were more concomitant treatments with benzodiazepines in GC (27.46%) and GB (28.41%) than in GA (8.86%), and more parapharmacy treatments in GB (17.96%) than in GC (6.33%). Following the operation, 113 patients had some sign or symptom that required medical attention: in GA 48 (10.83%), in GB 49 (16.06%), in GC 16 (13.22%). Mean days until functional recovery in patients with complications: in GA 5.72 (SD2.05); bleeding 3 (SD1), pain 6.40 (SD1.34), and infection 7.33 (SD0.57), with fewer days for bleeding than for pain or infection. GB: 27.96 (SD 28.42), bleeding 3 (SD0), pain 46.69 (SD31.36), infection 10.83 (SD3.90); lowest for patients with bleeding. GC: 9.44 (SD 2.50); for bleeding 7.66 (SD2. 08), pain 10.66 (SD1.15), infection 10 (SD3.46); no differences. Overall, for women with bleeding, the time was 4.16 days (SD1.94); less in GA and GB than in GC. Pain, at 31.33 days (SD 30.70), was the factor that most delayed functional recovery; in GB women, it took longer to return to work due to pain (45.96, SD31.36) compared to GA (6.4, SD 1.34) and GC (10.66, SD1.15). In women with infection, overall mean time was 10.11 days (SD 3.61) with no difference between groups. Conclusions: Mean time for the return to normal activity in patients who underwent TOT for SUI is 5 days if there are no complications, and 16.91 days if there are any. The ASA-SP risk group classification can be used to anticipate functional outcomes. An ASA-PS risk-based functional recovery forecasting protocol should be adapted, especially ASA II patients who may present with long-term disabling postoperative pain. Preventive management measures are proposed that favour functional recovery.

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Effect of Transobturator Midurethral Sling Placement on Urgency and Urge Incontinence

Abstract: TVT-O placement is associated with cure/improvement of U and UUI in a significant proportion of patients with mixed urinary incontinence. Further, the observed improvements in U/UUI persist at 12 months and appear to have a durable positive association with QOL.

Cited by 6 publications

References 20 publications

Burch Retropubic Urethropexy Compared With Midurethral Sling With Concurrent Sacrocolpopexy

Burch Retropubic Urethropexy Compared With Midurethral Sling With Concurrent Sacrocolpopexy

Effects of the transobturator tape procedure on overactive bladder symptoms and quality of life: a prospective study

The American Society of Anesthesiologists Physical Status (ASA-PS) Risk Group Classification Can Be Used to Anticipate Functional Recovery Outcomes after the Surgical Treatment of Female Urinary Incontinence with Transobturator Suburethral Tape

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