Evaluation of transobturator tension-free vaginal tapes in the management of women with mixed urinary incontinence: one-year outcomes.

Abstract

OBJECTIVE:

To assess the efficacy of transobturator tapes in the management of women with urodynamic mixed urinary incontinence (UI).

STUDY DESIGN:

A secondary analysis of a prospective randomized study; 83 women with mixed UI on urodynamics and predominant stress UI symptoms were recruited and randomly assigned to undergo "outside-in" or inside-out transobturator tapes. Preoperative assessment included urodynamic assessment and completion of validated symptom severity and quality of life (QoL) questionnaires. The primary outcome was patient-reported success rates at 1-year as assessed by the Patient Global Impression of Improvement (very much/much improved). Secondary outcomes included changes in preoperative urgency/urgency incontinence, changes in QoL scores and comparison between the 2 types of transobturator tapes.

RESULTS:

Seventy-seven women completed 1-year follow-up (outside-in [n=42] vs inside-out [n=35]). The patient-reported success rate and objective cure rate were 75% and 90%, respectively. At 1-year follow-up; 40 women (52%) and 31 women (57.4%) reported cure in their preoperative urgency and urgency incontinence, respectively. A total of 74% reported≥10 point improvement in QoL scores.

CONCLUSION:

In women with urodynamic mixed incontinence and predominant stress UI, transobturator tapes were associated with good patient-reported success rate at 1 year. Urgency/ urgency incontinence are cured in over 50% of women.

• Authors: Mohamed Abdel-fattah, Alyaa Mostafa, David Young, Ian Ramsay
• Journal: American journal of obstetrics and gynecology (Am J Obstet Gynecol) Vol. 205 Issue 2 Pg. 150.e1-6 (Aug 2011) ISSN: 1097-6868 [Electronic] United States
• PMID: 21640964 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2011 Mosby, Inc. All rights reserved.

Topics

• Adult
• Aged
• Confidence Intervals
• Evaluation Studies as Topic
• Female
• Follow-Up Studies
• Humans
• Middle Aged
• Odds Ratio
• Patient Satisfaction (statistics & numerical data)
• Preoperative Care (methods)
• Prospective Studies
• Quality of Life
• Risk Assessment
• Severity of Illness Index
• Single-Blind Method
• Suburethral Slings
• Time Factors
• Treatment Outcome
• Urinary Incontinence (diagnosis, surgery)
• Urinary Incontinence, Stress (diagnosis, surgery)
• Urinary Incontinence, Urge (diagnosis, surgery)
• Urodynamics