A Prospective Study of Surgeon and Patient-Perceived Outcome following Transobturator Tape Insertion for Treatment of Urodynamic Stress Incontinence

Abstract

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 19 min (15–30) and blood loss 21 mls (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.