Abstract

This study was aimed at Investigating the influence of the transobturator tape (TOT) procedure used in surgical treatment of stress urinary incontinence on objective and subjective cure rates, as well as quality of life. A total of 156 patients who were diagnosed as stress incontinence and mixed incontinence with stress predominancy, underwent a TOT operation under spinal anesthesia by one surgeon or two surgeons of the team. Transobturator vaginal tape (TVT)-obturator inside out material (TVT-O® (Gynecare) was used in the operation. All patients underwent preoperative and postoperative urodynamic tests and pad tests, and the results were compared. The objective and subjective cure rates were investigated in mean of 30.3 months of follow-up. The objective cure was evaluated with negative cough test and less than 8 g 24-h pad test, while the subjective cure was evaluated with Patient Global Impression of Improvement (PGI). All patients were given IIQ-7, UDI-6, UISS and VAS tests at least once and the influence of the operation upon quality of life was investigated. According to the result obtained, the mean follow up time was 30.3 ± 7.4 months (range 17 - 42). The objective cure rate was found to be 84.6% (132 patients), the subjective cure rate was found to be 89% (139 patients) and the failure rate was found to be 10.8% (17 patients). Preoperative and postoperative pad test results of the patients were found to be statistically significant (38 ± 22.3 vs. 1±2.6 p<005). Among urodynamics and symptoms evaluated pre- and postoperatively, a statistically significant difference was detected between the Q tip test (43.60 vs. 20.8), leaks over 24 h (4 vs. 0), daytime frequency/nocturia (0.95 vs. 0.58) and maximum urethral closure pressure (57.3 vs. 35) (p<0.05). The preoperative and postoperative incontinence impact questionnaire-short form (IIQ-7) (11 vs. 0.6), urogenital distress inventory-short form (UDI-6) (14 vs. 7), urinary incontinence severity score (UISS) (11 vs. 2.8) and the visual analogue scale (VAS) (68 vs. 8) quality of life tests showed a significant difference (p<0.05). Summarily, the objective and subjective cure rates of the TOT procedure in the surgical treatment of female stress incontinence were quite high, thus it is an effective technique. The influence of this operation on quality of life scores evaluated with various parameters is satisfying.

Key words: Transobturator tape (TOT), objective and subjective cure rates, urinary incontinence.