| Effects of Transobturator Adjustable Tape Sling Procedure on the Therapeutic Outcome in Patients with Stress Urinary Incontinence and Detrusor Underactivity. |
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| Dae Gi Jo, Seung Ae Yang, Ju Tae Seo |
1Department of Urology, Cheil General Hospital, Kwandong University College of Medicine, Seoul, Korea. jtandro@cgh.co.kr
2College of Nursing, Sungshin Women's Universitiy, Seoul, Korea. |
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| ABSTRACT |
PURPOSE
To evaluate the outcome and efficacy of transobturator adjustable (TOA) tape sling operations on women with intrinsic sphincter deficiency (ISD) and/or detrusor underactivity (DU) combined with stress urinary incontinence (SUI).
MATERIALS AND METHODS
This retrospective analysis comprised 60 TOA patients. 30 patients hadDU (Qmax < 15ml/s) and/or ISD (Valsalva leak point pressure;VLPP < 60cmH20) on the preoperative UDS and the rest only had SUI. I-QoL, visual analog scale (VAS), Patient's Perception of Urgency Severity (PPUS), and Self-Assessment/Sandvik Questions were performed before and 1 year after surgery. The mesh tension was controlled at 1 day after surgery. The objective cure rate was defined as no leakage using the cough test with a full bladder.
RESULTS
Patients were divided into two groups: Group A:SUI with ISD and/or DU, n=30; Group B:only SUI without ISD and DU, n=30. The two groups showed a difference in Qmax and VLPP preoperatively. Objective success rates were 18 (60.0%) completely cured, 10 (33.3%) improved in Group A, and 23 (76.7%) completely cured, 7 (23.3%) improved in Group B.
Three cases needed tape-tension adjustment due to urinary leakage one-day after surgery (2 in Group A, 1 in Group B).
There was no postoperative urinary retention.
CONCLUSIONS
After TOA for SUI with ISD and/or DU, 3 cases were needed tension adjustment after surgery. TOA procedures seem to be effective and safe, more clinical studies with long-term follow up are required for a definite conclusion. |
| Keywords:
Transobturator tape; Urodynamics; Stress urinary incontinence |
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