Transobturator Tape: Over 10 Years Follow-up - 28/07/19
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Abstract |
Objectives |
To assess subjective and objective outcomes in incontinent patients following “out-in” TOT, at >10-year follow-up; to evaluate effect on quality of life and other urinary symptoms, late adverse events and predictive factors for failure.
Methods |
This single-centre prospective study evaluated women with “complicated” or “uncomplicated” stress urinary incontinence (SUI) following “out-i”’ TOT between 2003 and 2007.
The pre-op work-up comprised: history; pelvic examination; cough stress test; urodynamic study; UDI-6; and King's Health questionnaires.
Work-up was the same as pre-op plus the Patient Global Impression of Improvement scale with final follow-up in 2017.
Results |
One hundred thirty six consecutive patients underwent TOT; at final follow-up (mean 145 months) we evaluated 123. Cure rates: objective: 78.9%; subjective: 62.6%; no significant deterioration in SUI cure rates over time.
Urgency and urgency urinary incontinence (UUI) significantly reduced. Voiding dysfunction increased without urodynamic obstruction. De novo urgency appeared in 7.3% and de novo UUI in 4.1%.
In the 31 uncomplicated SUI patients, the objective cure rate was 87.1% and the subjective cure rate was 72.2%. De novo urgency appeared in 9.7% and de novo UUI in 3.2%.
Nine King's Health questionnaires domains saw statistically significant improvements.
In univariate analysis, pre-op wet OAB was associated with subjective recurrent SUI (P < .038) and parity >2 was associated with objective recurrent SUI (P = .023).
We had 5 cases of partial mesh exposure.
Conclusion |
Cure rates are satisfactory, 10 years after TOT surgery, with good quality of life and few major complications. However, some postoperative symptoms may be caused by long-term treatment failure or by advancing age or another pathology.
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Declaration of Interest: None. |
Vol 129
P. 48-53 - juillet 2019 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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