Surgical treatment of stress urinary incontinence: A 3-year follow-up

Abstract

OBJECTIVES: To evaluate the objective and subjective midterm outcomes of transobturator tape (TOT) in the treatment of female stress urinary incontinence (SUI). MATERIALS AND METHODS: A total of 114 consecutive patients affected by stress urinary incontinence (mean age 59±10 years), who underwent the TOT procedure between July 2004 and May 2008 (46 patients received the Safyre, 30 patients the PelviLace, 20 patients the Monarc, 10 patients the DynaMesh and 8 the Align sling), were assessed in June 2008. An evaluation of the patients, based on history, physical examination, stress test, urodynamic tests, and the compilation of two specific quality of life questionnaires, was performed before and after surgery. RESULTS: The therapeutic midterm failure rate for the TOT procedure was 4.4% (5 of 114 patients). The midterm cure rate was 95.6% (109 of 114 patients), 7 (6.1%) of those patients only improved, still with minimal residual urinary leakage. Clinical signs for bowel, urethral, or bladder injuries were undetectable. Intraoperative bleeding, postoperative field infections, or postoperative pelvic floor relaxations were not noted. Three patients (2.6%) presented a little small area of mesh erosion within 6 months from surgery. We also noticed a few obstructive symptoms and irritative symptoms: 4 of 114 (3.,5%) patients showed urge de novo urge symptoms. A high grade degree of satisfaction was assessed reported by QoL questionnaires ( p<0.001). CONCLUSLONS: The midterm results of this study show that the TOT procedure is a simple, safe, and effective technique in thefor treatingment of female stress urinary incontinence. © 2008 Urogynaecologia T. J.