The Evaluation of Long-Term Outcomes of Outside-in Transobturator Tape Procedure in the Treatment of Stress Urinary Incontinence
Alim Gökhan Kuşgöz1, Ertuğrul Can Tüfekçi2, Fisun Vural2, Ayşe Deniz Ertürk Coşkun21Department of Obstetrics and Gynocology, Special Izmiryolu Sevgi Hospital, Balıkesir, Türkiye
2Department of Obstetrics and Gynocology, Haydarpaşa Numune Training and Research Hospital, University of Health Science, İstanbul, Türkiye
INTRODUCTION: The objective of the study was to investigate the objective-subjective success rates and complications of outside-in transobturator tape (TOT) surgery with urinary distress inventory (UDI)-6 questionnaire and subjective assessment after 5 years follow-up.
METHODS: We analyzed 60 women with stress urinary incontinence who underwent outside-in TOT procedure by the same surgeon and mesh, and were followed up after 5 years. All patients’ gynecological examination findings, stress test, Q-tip test, pad test, residual urinary volume, UDI-6 questionnaire, and duration of operation and complications were recorded. 3 years and 5 years after surgery, all patients were evaluated for anatomic-functional outcomes and subjective patient satisfaction.
RESULTS: The mean age of the population was 51.92±7.31 years, and 50% of the women were postmenopausal. Two patients (3.3%) had intraoperative bladder injury. Among long-term complications, one patient had (1.6%) de novo urge incontinence. There was no mesh erosion in the 5 years follow-up. When we compared the pre-operative and 5-years post-operative Q-tip test angles, a significant decrease was observed (63.92±14.17; 25.08±9.68) (p=0.001). UDI-6 question 3,4 survey scores were also significantly lower in the 5th year follow-up (p=0.001) At the end of 5 years, we observed an objective success in 82.9% of the patients. The patients also reported a subjective improvement of 82.9%.
DISCUSSION AND CONCLUSION: If proper surgical technique is used, outside-in TOT procedure is an efficient and safe method with high objective and subjective cure rates and low complication rates after a 5 year follow-up.
Corresponding Author: Alim Gökhan Kuşgöz, Türkiye
Manuscript Language: English