Transobturator tension-free tape in the treatment of patients with mixed urinary incontinence: long term results
Article authors
Urology Department of Moscow State University of Medicine and Dentistry, Moscow, Russia
Introduction & Objectives:
We aimed to evaluate to efficacy of transobturator midurethral synthetic slings on patients suffering with mixed urinary incontinence (MUI). This study presented long term objective and subjective results.
Materials & Methods:
Group 1 included women with pure SUI. Group 2 included the patients suffering from mixed urinary incontinence with prevalence of stress symptoms. All patients were underwent TVT-0 procedure (Ethicon, Somerville, USA). During follow up visits patients were undergone thorough physical and vaginal examination with consequent cough stress test, uroflowmetry and post void residual urine. The patients were asked to express they satisfaction with antiincontinence surgery via visual analogue scale.
Results:
Two hundred and seventy six patients were treated with TVT-0 slings. Among these patients 211 suffered pure stress urinary incontinence (Group 1, mean age of 54.14±9.31) and 65 women (Group 2, mean age of 52.12±7.13) presented with mixed urinary incontinence. There were no significant differences in patient characteristics such as age, menopause, parity, and number of pregnancies between the two groups. The results of the study are presented in the table 1.
There were no statistically significant differences in objective and subjective cure rates on short and long term follow ups among patients suffering pure stress (30,1 months) and mixed (32,6 months) urinary incontinence.
| Evaluation of efficacy | Group 1 (SUI) N=211 | Group 2 (MUI) N=65 | p-value (Fisher exact test, two-tailed) |
| Early follow up (1 month) | |||
| Cough test negative (%) | 203 (96.21%) | 64 (98.46%) | 0.690 |
| Not satisfied with surgery (%) | 28 (13.27%) | 10 (15.38%) | 0.171 |
| Satisfied (%) | 77 (36.49%) | 16 (24.62%) | 0.098 |
| Very satisfied (%) | 106 (50.24%) | 39 (60.0%) | 0.116 |
| Long term follow up | |||
| Mean follow up time | 30.1±3.0 months | 32.6±8.6 months | |
| Cough test negative (%) | 178 (84.36%) | 56 (86.15%) | 0.845 |
| Not satisfied with surgery (%) | 30 (14.22%) | 8(12.31%) | 0.838 |
| Satisfied (%) | 85 (40.28%) | 22 (33.85%) | 0.385 |
| Very satisfied (%) | 96 (45.50%) | 35 (53.85%) | 0.258 |
Table 1. Objective and subjective results among SUI and MUI patients.
Conclusions:
Mixed urinary incontinence with predominance of stress component may be successfully treated with TVT-0 procedure. The objective and subjective cure rates for the patients suffering with MUI within 32.6±8.6 months of follow up were 86.15% and 87.69% respectively, which is comparable to results for the patients with SUI treated with similar sling.
