Recurrence rate of stress urinary incontinence in females with initial cure after transobturator tape procedure at 3-year follow-up

Abstract

PurposeTo assess recurrence rates of urinary incontinence in women with initial cure after transobturator tape (TOT) procedure at 3-year follow-up.Materials and MethodsBetween June 2006 and May 2013, a total of 402 consecutive patients underwent the TOT procedure for female stress urinary incontinence (SUI) at Dongguk University Ilsan Hospital. Of the 402 patients, 223 had sufficient medical records for analysis. Therefore, they were followed-up for 3 years postoperatively. Patient characteristics, urinary symptoms, physical examination, and urodynamic parameters were evaluated. The primary end point of “cure” was defined as the absence of any complaint of urinary leakage without needing pads for usual activities.ResultsOf the 223 patients, 196 patients (87.9%) were initially cured within 6 months postoperatively. Of the 196 patients, 70 (35.7%) had recurrent urinary incontinence at 3 years postoperatively, 51 (26.0%) had SUI, 16 (8.2%) had urgency urinary incontinence, and 3 (1.5%) had mixed urinary incontinence. In univariate analysis, preoperative urinary obstructive symptom was found to significant contributor to the recurrence of urinary incontinence at 3-year postoperatively (p=0.004).ConclusionsIn our study, 35.7% of the women with initial cure after TOT experienced the recurrence of urinary leakage during the 3-year follow-up. The cure rate of TOT was decreased as time went by, although the initial cure rate was high.

A Comparative Study on the Clinical Efficacy of Simple Transobturator Midurethal Sling and Posterior Pelvic Floor Reconstruction

“…Although the difference between the two groups was small, the curative effect of the treatment group of pelvic floor reconstruction after TOT was better than that of the simple TOT group. Compared with other TOT operations reported in the literature, our surgery has a higher cure rate [ 13 ]. In the meta-analysis and evaluation of the short-term efficacy and adverse reactions of Ajust single incision micro urethral sling operation (Ajust operation) compared with standard middle urethral sling operation (TVT-O/TOT) by Wei et al, [ 14 ] 233 cases in TVT-O/TOT group were reported.…”

Complicaciones intraoperatorias y posoperatorias de las cintas medio uretrales libres de tensión en incontinencia urinaria de esfuerzo

“…(32) En nuestro grupo de estudio el 2.9% necesito de dilataciones uretrales previa a la cateterización uretral continuo, solo un caso requirió movilización de la cinta dentro de las 2 semanas posteriores a la operación. (33) La exposición de malla tiene tasas de 0.8 a 5%, (10,11,27,34,35) y puede sobrevenir entre 3 semanas y 18 meses. (31) Vishwanath y su grupo reportaron extrusión de la cinta a las tres semanas de la intervención en 1 de 150 pacientes (1.5%), que era diabética y posmenopáusica y se trató con resección de la malla sin complicaciones.…”

Opinion: pelvic floor disorders: learning from chronicity & chronic care models

“…Evidence on treatments for incontinence and prolapse from high income settings show that conservative management including pelvic floor muscle training can be effective, with studies showing cure being reported up to six times more for urinary incontinence vs. non-intervention ( 11 – 13 ). Surgical options are appropriate for women who have exhausted conservative management but are associated with high rates of reoccurrence ( 14 , 15 ). There is interest in whether similar models of conservative management would be appropriate and effective in lower-income country contexts.…”