Transobturator tape for female stress urinary incontinence: short term results after surgical procedure

A. Han, O. S. Aksakal, C. H. Ark, A. M. Misirlioglup, I. Alkis, M. Bakacak, M. Doganay

Abstract: The aim of the present prospective study was to assess the success and safety of TOT Trans-Obturator-Tape (TOT) operation using the manipulation of 45 degree reverse trendelenburg position in lithotomy for adjusting the tension of vaginal tape for each patient. Methods. Between June 2005 and April 2006, a total of 80 patients underwent TOT operation in which intraoperative 45 degree reverse terendelenburg position for adjusting tension rate of tape was used at Zekai Tahir Burak Women Health and Research Hospital, Turkey. The pre- and postoperative assessments included medical history, pelvic examination, BMI (kg/m2), International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF, Turkish version), urine analysis, stress test (cough provocation), one-hour pad test, URA measurement via transperineal ultrasonography and urodynamic studies were conducted in all of preoperative cases in order to support diagnosis and in postoperatively unsuccessful cases in order to have a much adequate understanding of the machinery of this condition. The majority of patients (64/80, 80%) underwent one or more concurrent surgical procedures at the time of their TOT procedure. A non-elastic polypropylene monofilament tape was placed under the mid-urethra. Results. The mean follow-up period was 6.4 months (2-13). Success rate was 92.5%. The total perioperative complication rate was 3.75% (3/80). URA has changed in the range of 0º-50º (mean 16.5º). The postoperative complication rate was moderate (7.59%). None of the patients developed urinary retention. Conclusions. TOT is an effective and safe procedure for the treatment of genuine stress incontinence and the intraoperative adjustment of tension of vaginal tape using reverse terndelenburg position maybe helpful for improving success of operation.
DOI:10.18643/gieu.2013.72

Keywords: trans-obturator-tape, transperineal ultrasound, urinary incontinence