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Short and Long Term Follow up and Efficacy of Trans Obturator Tape for Management of Stress Urinary Incontinence

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Abstract

Background

Stress urinary incontinence (SUI) is involuntary leakage of urine on raised intra- abdominal pressure which adversely affects quality of life usually requiring surgical treatment.

Methods

This is a prospective study of efficacy, cure rates and complications of tension free transobturator tape (TOT) surgery on 85 women with SUI. Pre-operatively and 6 months post-operatively International consultation on Incontinence Questionnaire – Short Form (ICIQ-SF) scores were calculated for all patients to know the severity of incontinence and efficacy of tape.

Results

Mean age, parity, body mass index and mean duration of symptoms were 45.78 years, 2.68, 26.38 kg/m2 and 3.85 years, respectively. SUI was demonstrated in all cases on cough stress test and Bonney’s test. Mean operative time, blood loss, post-operative analgesic injections, post- operative stay and post- operative catheterisation were 23.28 min, 45.50 ml, 1.2 injections, 1.2 days and 1.2 days. Various complications noted were excessive bleeding (3.52%), urinary retention (7.05%), urinary urgency (8.23%), urinary tract infection (2.35%), surgical site infection (1.17%), groin pain (28.23%) and mesh exposure (3.52%). At 6 months follow-up, the complete cure rate was 83.52% , partial cure rate was 11.76% and failure rate was found to be 4.70% whereas it was 79.16%, 12.0% and 8.33% respectively at 3 years follow up. 2 patients (2.35%) required burch colposuspension and 12 patients (14.11%) required pelvic floor exercises and duloxetine therapy for their symptoms. Mean pre- operative ICIQ-SF score reduced post- operatively (17.8 ± 4.67 to 2.71 ± 1.42) (p value = 0.001).

Conclusion

Study demonstrates short and long-term efficacy and safety of TOT for surgical management of SUI.

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Acknowledgements

We are thankful to department of Obstetrics and Gynecology and residents for their help in the study.

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The authors have no financial disclosures to make.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Room No. 3064A, III Rd Floor, Teaching block, New Delhi, 110029, India

    J. B. Sharma, Karishma Thariani, Rajesh Kumari, Tanudeep Kaur, Bharti Uppal, Kavita Pandey & Venus Dalal

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  1. J. B. Sharma
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  2. Karishma Thariani
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  3. Rajesh Kumari
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  4. Tanudeep Kaur
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  6. Kavita Pandey
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  7. Venus Dalal
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Contributions

All authors have made significant contribution for preparation of this manuscript following ICMJE guidelines. First and second author share the first position.

Corresponding author

Correspondence to J. B. Sharma.

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Ethical Approval

All procedures followed were in accordance with the Ethical Standard of the Responsible Committee on Human Experimentation and with the Declaration of HELSINKI of 1975, as revised in 2008. Informed consent was obtained from the patient. The study was conducted in department of Obstetrics and Gynecology in collaboration with department of Microbiology and Department of Medicine. The work is designed and was performed after taking ethical clearance from the Institutional ethical committee. Permission was taken by the institute’s ethics committee.

Conflict of interest

All the authors declare no conflict of interest. The authors have no financial disclosures to make.

Informed Consent

Informed consent was taken from all patients for being involved in the study.

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J.B. Sharma: Professor, FRCOG, PhD, Karisma Thariani: Urogynaecology Fellow, MD, Rajesh Kumari: Associate Professor, MD, Tanudeep Kaur: Urogynaecology Fellow, MD, Bharti Uppal: Urogynaecology Fellow, MD, Kavita Pandey: Urogynaecology Fellow, MD, Venus Dalal: Senior resident, MD

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Sharma, J.B., Thariani, K., Kumari, R. et al. Short and Long Term Follow up and Efficacy of Trans Obturator Tape for Management of Stress Urinary Incontinence. J Obstet Gynecol India 71, 285–291 (2021). https://doi.org/10.1007/s13224-020-01398-2

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