Transobturator Tape Operation Is More Effective in Premenopausal Women than in Postmenopausal Women with Stress Incontinence

Abstract

PurposeMidurethral synthetic slings for female stress urinary incontinence are minimally invasive polypropylene mesh tapes that are inserted under the midurethra with trocars. In the past decade, this new technology has become the most commonly performed procedure for female stress urinary incontinence, replacing the traditional open procedures. However, its effectiveness in pre- and postmenopausal women has not previously been compared.Materials and MethodsWe assessed the clinical outcome of the transobturator tape (TOT) procedure in premenopausal (n=45) and postmenopausal (n=49) women by means of self-report and the Urinary Distress Inventory 6 (UDI-6) questionnaire.ResultsThe mean age of the pre- and postmenopausal women was 44 and 60 years, respectively. Mean parity was 2.4 and 3, respectively. There were no significant differences with respect to mean operation time, duration of hospitalization, or intraoperative and postoperative complications. However, premenopausal women were more satisfied with the operation than were postmenopausal women (p=0.014). Also, UDI-6 scores were significantly better in premenopausal women (p=0.027).ConclusionsThe TOT operation appeared to be more effective in premenopausal women with stress urinary incontinence. However, further studies with larger sample sizes are needed to confirm our results.

Influence of age, menopause, pelvic muscle exercises, urethral hypermobility and concomitant surgery on the outcomes after the transobturator tape procedure (factors effecting TOT outcomes)

“…In our study, treatment success was achieved in 46 out of 53 patients (86.8%) on assessments performed before the discharge and at days 7 and 30, postoperatively, and the patients reported total relief of symptoms of SUI. This success rate is in conformity with those reported in the literature [13,20,21].…”

“…Previous studies have shown that the TOT procedure might be associated with some complications such as prolonged bleeding, surgical site infection, re-operation due to mesh erosion and leg/groin pain [8,13]. In our study, complications occurred in 4 patients, 2 (3.8%) of which sustained bladder trauma and the other 2 (3.8%) had leg pain.…”

“…Thus, factors affecting the success rate and the complication rate have been extensively evaluated in numerous studies [13,19]. Various parameters are available to evaluate the outcomes of the treatment.…”

“…However, traditional colposuspension surgery and vaginal sling procedure have increasingly lost their reputation due to high morbidity and a low overall success rate associated with these procedures. In the last decade, midurethral synthetic sling procedures such as the transobturator tape (TOT) procedure have become the most commonly performed surgical method [13].…”

Evaluation of treatment success in patients undergoing transobturator tape surgery

“…In this study which was reported in 2011 by Dursun et al 45 premenopausal and 49 postmenopausal women to whom TOT was performed for the treatment of urinary incontinence were compared and it was concluded that TOT was more effective in premenopausal women (8) .…”