Two-Year Follow-Up Results of Transobturator Tape Procedure with and without Concomitant Vaginal Surgery

Abstract

Objective: This study aims to evaluate the subjective and objective outcomes of the transobturator tape (TOT) procedure performed to treat stress urinary incontinence and to determine the efficacy and safety of the TOT procedure when used along with vaginal surgery. Methods: This is a prospective review of 24 women who had the TOT procedure done only due to stress incontinence; 22 women who underwent concomitant TOT and pelvic floor repair; and 20 women who received concurrent TOT, transvaginal hysterectomy, and sacrospinous ligament fixation. Results: When compared to the patients who had TOT with pelvic floor repair, the patients who underwent TOT with hysterectomy declared to have more dyspareunia (p = 0.008) and they were found to have significantly higher post-void residual volume (p = 0.014). When compared to the patients who had only TOT, the patients who underwent TOT with hysterectomy claimed to have more pelvic pain (p = 0.012) and significantly higher post-void residual volume (p = 0.020). Conclusion: The TOT procedure results in moderately high objective cure rates, and concurrent application of pelvic floor repair or transvaginal hysterectomy does not affect these rates. The relatively higher incidences for voiding problems and pelvic pain in women who underwent TOT, hysterectomy, and sacropinous fixation simultaneously suggest that the extent of surgery directly correlates with the severity of postoperative complications.

Outcome of transobturator sling for treatment of female stress urinary incontinence applied as a single procedure or concomitantly with pelvic organ prolapse surgery

“…Most published studies show equal efficacy of TOT used as a single procedure or combined with prolapse surgery [18][19][20][21]. Only the results of 2 studies revealed a better outcome for sling performed concomitantly with prolapse surgery [22,23].…”

Narrow Vagina as a Predictor of Obstructive Voiding Dysfunction after Transobturator Sling Surgery

“…According to a meta-analysis, <40% of surgeons use validated questionnaires to assess urinary symptoms to evaluate the effectiveness of SUI surgeries [17]. After female MUS, publications of VD most commonly consider PVR as the end point of the studies [8, 12, 18, 19]. It is non-invasive, measurable by ultrasound, reproducible, comparable, traceable, and a key indicator for further therapeutic decisions.…”

“…For this reason, and because subjective complaints are difficult to define, measure, compare, or reproduce, the primary end point of the study was considered to be objectively measurable PVR >50 mL. Since there is no clear definition of “significant PVR,” in general, PVR above 100 mL is interpreted as such [8, 12, 18, 19]. Other authors used the 50-mL limit because, among their patients with postoperative VD, the ratio of PVR 50–100 mL were higher than those PVR above 100 mL (7.1% vs. 2.6%) [24].…”