Comparison of the outcomes of the TOT technique using a hand-made TOT Material and a commercial one

Abstract

Aim: The purpose of this study was to compare the effectiveness of handmade transobturator tape (TOT) devices (tailored polypropylene mesh by the surgeon during the operation) with commercially available ones. Materials and methods: We included 78 consecutive women with the complaint of pure stress urinary incontinence recalcitrant to lifestyle modifications, pelvic floor muscle training, and medical treatment. The patients underwent TOT procedures either with a commercially available product (I-Stop, CL Medical, Lyon, France) (group 1) or with a device prepared during the operation with polypropylene mesh of 35 × 2 cm in size (Prolen, Ethicon Inc., Somerville, New Jersey, USA) (group 2). The patients were followed for at least 18 months and cure was defined as the absence of any episodes of involuntary urine leakage during stressful activities and/or the stress cough test. Results: Thirty-two (group 1) and 46 (group 2) patients underwent TOT surgery. Mean operation time was slightly shorter in group 1 compared to group 2 (20.53 ± 4.88 vs. 22.93 ± 4.84, P = 0.035); however, mean duration of the indwelling catheter was less than 1 day in both groups (P = 0.444). None of the patients had incontinence or urinary retention postoperatively. The cure rates in groups 1 and 2 were not significantly different at the end of the 1st (87.5% vs. 87%, P = 0.944) and 2nd (78.1% vs. 80.4%, P = 0.804) postoperative years. Conclusion: TOT procedures performed with polypropylene mesh and No. 1 silk line are as effective and safe as commercially available TOT devices. © TÜBİTAK.