Quality of life assessment in women with stress urinary incontinence following Trans Obturator Tape (TOT) insertion: a prospective study

Abstract

INTRODUCTIONStress urinary incontinence is a symptom or sign indicating that the woman has involuntary loss of urine associated with exertion in the absence of detrusor contraction. It has a significant impact on quality of life. It's prevalence varies from 4% to 35% depending upon the variation in population studied. 1 The treatment options include initial conservative therapies (i.e., lifestyle interventions, pelvic floor muscle training, and bladder training), followed by surgery, which is an option for women whose quality of life is still impaired after a diagnosis of genuine stress incontinence. In transobturator tape (TOT) procedure, a small incision is placed in the groins and in the vagina under the urethra. The mesh is placed under the urethra in the correct position without having to pass needles blindly through the retropubic space, as in transvaginal tape (TVT). The ABSTRACT Background: Stress urinary incontinence is a symptom or sign indicating that the woman has involuntary loss of urine associated with exertion in the absence of detrusor contraction. It has a significant impact on quality of life. TOT insertion is a popular procedure being done now. Studies related to quality of life assessment following Trans obturator tape (TOT) insertion is sparingly reported. Objectives of present study were to evaluate the quality of life following TOT insertion in patients with stress urinary incontinence and to assess the post operative complications. Methods: This is a prospective study done in the Department of Obstetrics and Gynecology, Government Medical College, Thrissur from January 2015 to December 2016. 48 women with Stress urinary incontinence who underwent TOT insertion were included in the study, out of which 30 patients were followed up. The King's Health Questionnaire was used for assessment. Data was analyzed using Epi Info 7 and Microsoft Excel. The statistical analysis was done using student t-test. Results: At 6 months follow up 86.66% (26) of patients had significant improvement in quality of life. 2 patients (6.66%) had postoperative voiding dysfunction, required recatheterisation, discharged after relief of symptoms. 2 patients (6.66%) had urge incontinence, advised medical management and was sent home, showed no improvement even after 6 months. 2 patients (6.66%) had continuous incontinence, fistula ruled out. Now they were lost to our follow up. Most common late post operative complication was groin pain. None had mesh erosion, bladder and bowel injuries. Conclusions: TOT is a safe and effective procedure for the treatment of stress urinary incontinence (SUI) which significantly improves the quality of life.

The role of trans obturator tape as a surgical procedure for female stress urinary incontinence and its impact on quality of life in Jammu region

“…15 Some other workers who also used KHQ for assessment of quality of life of women undergoing TOT placement also reported high range of improvement over different follow up times, Jacob et al, at six months follow up reported improvement in quality of life of 86.66% women and a reduction of 74.6% in the Part 2 domain of KHQ . 16 Jose et al, who questioned patients with a follow-up range of 7 to 29 months reported a median post-operative KHQ score of 66.66, which is higher than the post-operative KHQ score of patients of our study and could be attributable to difference in population and follow-up period. 17 Nevertheless, almost all the studies have reported that TOT placement brings up to a significantly measurable qualitative change in quality of life of affected patients as observed in present study.…”