International Urogynecology Journal

, Volume 24, Issue 10, pp 1639–1644

A prospective study of transobturator tape as treatment for stress urinary incontinence after transvaginal mesh repair

  • Hui-Hsuan Lau
  • Tsung-Hsien Su
  • Wen-Chu Huang
  • Ching-Hung Hsieh
  • Chin-Hui Su
  • Rhu-Chu Chang
Original Article

Abstract

Introduction and hypothesis

The transobturator suburethral sling is a common surgical treatment for stress urinary incontinence (SUI). In patients with incontinence after trocar-guided transvaginal mesh repair (Prolift™), data on outcome remain limited. In the present study, we hypothesized that transobturator tape in such cases is assumed to be as effective as surgery alone.

Methods

This was a prospective analysis of outcomes of transobturator slings in women who had undergone transvaginal mesh repair and in those who underwent sling surgery alone (controls). Objective cure was defined as the absence of urinary leakage during the stress test at filling cystometry and a negative cough test during pelvic examination. The success rates were evaluated 3–6 months postoperatively.

Results

One hundred women were recruited for the study. Compared to the control group, women after transvaginal mesh repair had a significantly lower objective success rate (62 vs 86 %, p = 0.005) and poorer bladder neck mobility (0.5 ± 0.8 vs 1.1 ± 0.5 cm, p = 0.001).

Conclusions

The transobturator sling has lower objective success rate in women after transvaginal mesh that may be due to decreased bladder neck mobility. Patients with post-mesh repair SUI who opt for sling surgery should be informed of these less satisfactory outcomes during preoperative counseling.

Keywords

Anti-incontinence surgery Pelvic organ prolapse Transobturator suburethral tape Urinary incontinence 

Abbreviations

SUI

Stress urinary incontinence

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Copyright information

© The International Urogynecological Association 2013

Authors and Affiliations

  • Hui-Hsuan Lau
    • 1
    • 2
  • Tsung-Hsien Su
    • 1
    • 2
    • 3
  • Wen-Chu Huang
    • 1
    • 2
  • Ching-Hung Hsieh
    • 4
  • Chin-Hui Su
    • 2
    • 5
  • Rhu-Chu Chang
    • 2
  1. 1.Department of Obstetrics and Gynecology, Division of Urogynecology, Department of Obstetrics and GynecologyMackay Memorial HospitalTaipeiTaiwan
  2. 2.Mackay MedicineNursing and Management CollegeTaipeiTaiwan
  3. 3.Taipei Medical UniversityTaipeiTaiwan
  4. 4.Department of Obstetrics and GynecologyClinic of Fu Jen Catholic UniversityTaipeiTaiwan
  5. 5.Department of OtorhinolaryngologyMackay Memorial HospitalTaipeiTaiwan

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