A prospective study of surgeon and patient-perceived outcome following transobturator tape insertion for treatment of urodynamic stress incontinence

Summary 

Introduction

Transobturator tape (TOT) placement for stress incontinence (USI) is recommended following failure of conservative therapy. The literature shows that in the short-term efficacy is comparable to tension-free vaginal tape (TVT) and open colposuspension (OC). The study aim was to report a large consecutive cohort undergoing TOT insertion by a single surgeon specifically for both surgeon- and patient-perceived outcome.

Patients and methods

Over 4 years at our institution 98 women underwent TOT insertion by a single surgeon. All women had preoperative urodynamics, 79% had type I and 21% type IIa USI. Perioperative and outpatient follow-up data were prospectively collected. Patient-perceived outcome was assessed using a mailed validated questionnaire.

Results

Results are similar to other published series. Median operative time was 19min (15–30) and blood loss 21mls (15–60). Self-catheterisation was necessary for 13 patients. Vaginal perforation occurred in two patients. At follow-up (mean 7.1 months) 86/93 (92%) patients were dry and 23 (26%) women reported urinary symptoms. 80 (81%) women responded to the questionnaire (mean 18 months) and 54 (68%) describing complete cure.

Conclusions

This large single-surgeon series confirms the safety and efficacy of TOT and illustrates the difference between surgeon and patient-perceived outcome. Results obtained are comparable to previously published series for TOT, TVT and OC.

Keywords: Urodynamic stress incontinence, Transobturator tape