Influence of Demographic and Clinical Factors on Surgical Outcomes of the Transobturator Tape Procedure in Patients with Stress Urinary Incontinence

Agarwal, Abhinav; Patnaik, Pranab; Shaw, Dipak; Rathee, Vazir Singh; Khan, Sartaj Wali; Jain, Madhu; Trivedi, Sameer; Dwivedi, US

doi:10.1159/000365703

Cited by 6 publications

(6 citation statements)

References 32 publications

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“…Stress urinary incontinence (SUI) is extensively accepted as a social problem and defined as the involuntary leakage of urine with effort ( 1 ). Generally, causes of incontinence are hypermobility due to the loss of urethral support and lower pressure transmission to the urethra, compared to the urinary bladder ( 2 ). In the last decade, mid-urethral sling surgery has become the standard procedure for treatment of SUI in women.…”

Section: Introductionmentioning

confidence: 99%

Female sexual function following a novel transobturator sling procedure without paraurethral dissection (modified-TOT)

et al. 2017

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Purpose To determine whether there is a difference in sexual function after modified and classical TOT procedures.Materials and Methods Of the 80 sexually active women with SUI, 36 underwent an original outside-in TOT as described by Delorme, and 44 underwent modified TOT procedure, between 2011 and 2015. The severity of incontinence and sexual function were evaluated using International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and Female Sexual Function Index (FSFI) questionnaires preoperatively and 3 months after surgery.Results The postoperative ICIQ-SF score was significantly lower than the preoperative ICIQ-SF score in both groups (p=0.004 for modified TOT and p=0.002 for classical TOT). There was no significant difference in the ICIQ-SF score reduction between the two groups (14.1±2.1 vs. 14.4±1.9; p=0.892). Complication rates according to the Clavien-Dindo classification were also similar in both groups. In both groups, difference between preoperative and postoperative FSFI scores revealed a statistically significant improvement in all domains. Comparison of postoperative 3-month FSFI scores of modified and classical TOT groups showed statistically significant differences in arousal, lubrication and orgasm domains. Desire, satisfaction, pain and total FSFI scores did not differ significantly between two groups.Conclusion The modified TOT technique is a simple, reliable and minimal invasive procedure. The cure rate of incontinence and complication rates are the same as those of the classical TOT technique. However, due to the positive effects of minimal tissue damage on sexual arousal and orgasmic function, modified TOT has an advantage over the classical TOT.

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Section: Introductionmentioning

confidence: 99%

Female sexual function following a novel transobturator sling procedure without paraurethral dissection (modified-TOT)

et al. 2017

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“…Agarwal et al reported that TOT surgery was more successful in premenopausal patients, those younger than 50 years, and those with a urethral mobility of greater than 30 degrees. 21 In contrast, Yasa et al showed that TOT surgery yielded as successful outcomes for the elderly and postmenopausal patients as for young and premenopausal women. 22 Esin et al compared obese and non-obese groups and found no effect for obesity on the results of TOT surgery.…”

Section: Discussionmentioning

confidence: 96%

Five-Year Efficacy of Transobturator Tape Treatment and Quality of Life in Women with Stress Urinary Incontinence

et al. 2020

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Background: We aimed to assess the results of first- and fifth-year outcomes and the effect on quality of life (QoL) of transobturator tape (TOT) treatment in patients with stress urinary incontinence (SUI). Methods: The patients who underwent TOT surgery between January 2008 and June 2013 were screened retrospectively. The QoL was evaluated with Incontinence Impact Questionnaire (IIQ-7) and Urogenital Distress Inventory-Short Form (UDI-6). The subjective evaluation of patients in terms of incontinence outcome was classified as worsened (UDI-6 and IIQ-7 if pre-operative < postoperative), improved (UDI-6 and IIQ-7 if pre-operative > postoperative), or cured (UDI-6 and IIQ-7 postoperative <10). The first-year and fifth-year success rates were compared between the IIQ-7 and UDI-6 results. Results: A total of 109 patients were included in the study. There was a significant improvement (P<0.001) in the patients’ UDI-6 and IIQ-7 scores when the preoperative and postoperative first-year results were compared. Comparing the postoperative first-year and fifth-year total UDI-6 and IIQ-7 scores, a significant improvement was observed and the patients’ complaints were significantly reduced (P<0.001). The results of the IIQ-7 and UDI-6 questionnaire revealed that the TOT surgery success rate was 93.3% at the end of the first year and 88.7% at the end of the fifth year. Conclusion: The postoperative first-year and fifth-year data reveal that TOT surgery has a high success rate and positive effects on QoL. Low complication rates and the ease of application make TOT a good alternative to other treatment modalities in surgical treatment of SUI.

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“…Yasa et al showed that TOT surgery in SUI treatment had high rates of success and patient satisfaction and a low postoperative morbidity rate in postmenopausal women aged over 65 years ( 15 ). Agarwal et al reported that TOT surgery was more successful in premenopausal women younger than 50 years with a urethral mobility greater than 30 degrees ( 16 ). In the present study, there was no difference between the postmenopausal and premenopausal groups in terms of TOT success and fifth-year follow-up evaluations.…”

Section: Discussionmentioning

confidence: 99%

The effects of menopause on the quality of life and longterm outcomes of transobturator tape treatment in women with stres urinary incontinence

et al. 2020

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Purpose: We aimed to investigate the effects of menopause on long-term outcomes of transobturator tape (TOT) surgery. Materials and Methods: Patients who underwent TOT surgery were evaluated under two groups as postmenopausal and premenopausal. The International Consultation on Incontinence short-form questionnaire (ICIQ-SF), Incontinence Impact Questionnaire (IIQ-7) and Urogenital Distress Inventory-Short Form (UDI-6) questionnaires were completed by the patients at the 1 st and 5 th -year follow-up sessions. Patients with a postoperative UDI-6 and IIQ-7 score of <10 were considered as cured, those with lower postoperative scores compared to the preoperative period were regarded as improved, and the cases that had higher postoperative scores than preoperative values were interpreted as TOT failure. The TOT success rates were compared between the results obtained from UDI-6 and IIQ-7. Results: A total of 109 patients were included in the study (53 postmenopausal and 56 premenopausal). We contacted with 90 (48 premenopausal and 42 postmenopausal) women at 1 st year control and 80 (44 premenopausal and 36 postmenopausal) women at 5 th year control. There was a significant improvement in all of three questionnaires between the preoperative and post-operative 1 st year control (ICIQ-SF: 15.5±2.5 vs. 1.8±4.3, p <0.001; IIQ-7: 68.9±9.8 vs. 2.75±15.2, p <0.001; UDI-6: 27.1±11.1 vs. 6.0±14.6, p <0.001) and the preoperative and post-operative 5 th year control (ICIQ-SF: 15.5±2.5 vs. 3.1±5.3, p <0.001; IIQ-7: 68.9±9.8 vs. 9.6±26.7, p <0.001; UDI-6: 27.1±11.1 vs. 5.1±10.0, p <0.001). When we compared the premenopausal and postmenopausal patients in terms of recurrent urinary tract infection (UTI); 5 (12%) patients had recurrent UTI in postmenopausal group but no patients had recurrent UTI in premenopausal group at 1 st year follow-up (p=0.039) and similarly the same 5 (13.9%) patients in follow-up had recurrent UTI in postmenopausal group but no patients had recurrent UTI in premenopausal group at 5 th year follow-up (p=0.045). There were no significant differences between the premenopausal and postmenopausal patients in terms of TOT success rates at 1 st and 5 th year control, evaluated with UDI-6 (1st year: p=0.198 and 5 th year: p=0.687) and IIQ-7 (1 st year: p=0.489 and 5 th year: p=0.608) questionnaires. Conclusions: Transobturator tape surgery is an effective and reliable method according to the long-term outcomes reported in this paper. In the current study, we determined that the TOT success rates were not affected by the presence of menopause.

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Influence of Demographic and Clinical Factors on Surgical Outcomes of the Transobturator Tape Procedure in Patients with Stress Urinary Incontinence

Cited by 6 publications

References 32 publications

Female sexual function following a novel transobturator sling procedure without paraurethral dissection (modified-TOT)

Female sexual function following a novel transobturator sling procedure without paraurethral dissection (modified-TOT)

Five-Year Efficacy of Transobturator Tape Treatment and Quality of Life in Women with Stress Urinary Incontinence

The effects of menopause on the quality of life and longterm outcomes of transobturator tape treatment in women with stres urinary incontinence

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