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Int Neurourol J > Volume 14(1); 2010 > Article
Clinical Investigation
International Neurourology Journal 2010;14(1): 20-25.
DOI: https://doi.org/10.5213/inj.2010.14.1.20   
Effects of Transobturator Adjustable Tape Sling Procedure on the Therapeutic Outcome in Patients with Stress Urinary Incontinence and Detrusor Underactivity.
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.
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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