Transobturatoric tape procedure for female stress urinary incontinence

Abstract

To assess the efficacy and safety of the transobturatoric tape (TOT) procedure as a treatment for female stress urinary incontinence (SUI). All patients (n=191) who underwent TOT between May 2003 and December 2004 were studied retrospectively. The study protocol involved recording of preoperative and perioperative details and postoperative subjective evaluation. The subjective outcome was assessed with two questionnaires at a mean of 20 and 34 months after the operation. The mean operation time of the patients without concomitant procedure was 19 min. The complication rate was low and postoperative recovery quick. The follow-up visit was scheduled 2-3 months after the procedure. The objective outcome assessment was done at the hospital for 50% of the patients, and the other half of the patients were followed up by their own gynecologist. During the follow-up visit (n=151), 79% of the women were cured: 90% of the patients with genuine SUI and 60% of those with mixed urinary incontinence (MUI). The data of 40 patients was either not available from patients' private gynecologists or the patients had not undergone a follow-up visit at all. For the first subjective outcome assessment, participating patients (n=188) received a questionnaire. Three patients had died from unrelated causes during this follow-up. The response rate was 82.4%. Overall, 83.9% of the respondents reported significant improvement, of which 90.5% of the patients had genuine SUI and 70.0% of the patients had MUI, respectively. During the second outcome assessment, the response rate was 85.1% (160/188). At a mean of 34 months postoperatively, 87.5% of the patients reported significant improvement: 94.5% of the patients with genuine SUI and 72.0% of those with MUI. The incontinence operation through the transobturatoric route is a safe and effective treatment, especially for patients with pure SUI. The rate of continence was sustained during a follow-up of 34 months.