MP-04.04: Comparison of TVT-SECUR and transobturator tape for outcome and patient satisfaction in female stress urinary incontinence

Introduction: We evaluate the impact of severe obesity on surgical outcomes of the transobturator tape (TOT) procedure in patients with stress urinary incontinence (SUI).Methods: In total, 32 women with severe obesity (body mass index [BMI] >35 kg/m2) were included in the study. All patients were preoperatively evaluated with history, pelvic examination, ultrasonography, and cough stress test. All patients completed the International Consultation on Incontinence Questionnaire-Short form (ICIQ-SF) preoperatively and at the postoperative followup. Cure of incontinence was defined as being completely dry after surgery. Cure was assessed subjectively and objectively. Subjective improvement defined as an International Consultation on Incontinence Questionnaire-Short form (ICIQ-SF) score ≤12 and satisfaction with surgery. Failure was defined as having no change or worsening of urinary incontinence after surgery. Postoperative patient satisfaction was assessed using a visual analog scale.Results: The mean follow-up time and mean BMI were 40.9 ± 20.9 months and 38 ± 3 kg/m2, respectively. According to preoperative ICIQ-SF questionnaire scores, 20 patients (62.5%) had severe and 12 patients (37.5 %) had very severe urinary incontinence symptoms. No patient had slight or moderate symptoms. None of the patients experienced worsening symptoms after surgery. Objective cure, subjective cure, subjective improvement and patient satisfaction rates were 81.2%, 46.8%, 37.5%, and 84.3% respectively. Our overall complication rate was 9.3%. None of the patients experienced intraoperative complications.Conclusion: In experienced hands, TOT is an effective and safe procedure to treat SUI, with minimal complications in severe obese women.

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Tension-Free Vaginal Tape, Transobturator Tape, and Own Modification of Transobturator Tape in the Treatment of Female Stress Urinary Incontinence: Comparative Analysis

BioMed Research International ◽

10.1155/2014/347856 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 8

Author(s):

Marcin Zyczkowski ◽

Krzysztof Nowakowski ◽

Waclaw Kuczmik ◽

Tomasz Urbanek ◽

Zbiegniew Kaletka ◽

...

Keyword(s):

Urinary Incontinence ◽

Stress Urinary Incontinence ◽

Comparative Evaluation ◽

Transobturator Tape ◽

Study Groups ◽

Female Stress Urinary Incontinence ◽

Single Center ◽

Single Center Experience ◽

Total Incidence ◽

Maintenance Time

Introduction. This study is a comparative evaluation of the TVT, TOT, and our own modification of TOT (mTOT) in the treatment of female stress urinary incontinence from a single center experience.Material and Methods. The study was conducted on 527 patients with SUI diagnosed on the basis of urodynamic studies. They were divided into three groups—TVT:n=142, (TOT):n=129, and mTOT:n=256. All of the patients underwent evaluation at 1, 3, and 6 months after surgery. Results were statistically analysed and compared.Results. Objective and subjective effectiveness after the surgery were not significantly different in the study groups and ranged from 90.1% to 96.4%. Mean surgery time was 32.3, 28.2, and 26.4 in the TVT, TOT, and mTOT, respectively. Mean hospitalization time was 2.51 days. Mean catheter maintenance time was significantly higher in the TVT than in other groups. In the TVT group total incidence of complications was 13.4%, and it was significantly higher than that in TOT and mTOT (9.3% and 8.6%, resp.).Conclusions. TVT, TOT, and mTOT are highly effective and safe methods in the treatment of SUI. There are no differences in the efficacy between the methods with a little higher percentage of complications in the TVT group.

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