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Satisfaction rates 10 years after trans-obturator vaginal tape
IUGA Academy. Mikos T. Jun 30, 2018; 213051
Topic: Stress Incontinence
Themistoklis Mikos
Themistoklis Mikos

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Satisfaction rates 10 years after trans-obturator vaginal tape

Mikos, T1; Pantazis, K1; Lioupis, M1; Tolkos, A1; Papanicolaou, A1; Grimbizis, G1

1: 1st Department Obstetrics & Gynecology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece

Introduction: Mid urethral slings (MUS), be it a retropubic tension-free vaginal tape (TVT) or a trans-obturator vaginal tape (TOT/TVT-O) represent the gold standard for the management of female stress urinary incontinence (SUI). Early studies, dating 15-20 years ago, have shown that continence rates after TVT can be, as high as, 85% during the first 2-3 years after the procedure. Long term outcomes are now available and should be taken into account when counselling women with incontinence

Objective: The aim of the study is to define patient satisfaction rates 10 years after surgical correction of SUI with transobturator tension-free vaginal tape (TOT).

Methods: Retrospective cohort study based on telephone interview. Urogynecology Department of a tertiary gynecology center. Inclusion criteria: patients who had TOT procedure, either as a standalone operation or as combined one, between January 2005 and December 2007 for SUI or mixed urinary incontinence (MUI) . Exclusion criteria: patients who had previous anti-incontinence surgery. All clinical data were collected from the hospital electronic medical records. The telephone interview took place in January 2018. The Patients’ Global Symptoms and Improvement (PGI-S and PGI-I) questionnaires for POP and urinary incontinence (UI) were used. Statistical analysis was performed with SPSS v. 17.00 software.

Results: A total of 174 patients (mean age 62.7-years-old) underwent TOT procedure between 2005-2007. Of them, 92 were unavailable to contact on their registered phone numbers (non-responders 52.9%). Three women died during the follow-up period (1.7%). Of the remaining 79 women none reported any immediate or long-term post-operative complications. Three women had re-operation for SUI because of incontinece recurrence (3.8%). 17 of 73 (23.3%) reported none or mild urinary incontinence symptoms on PGI-S, while 49 of 73 women (67.2%) reported moderate to significant improvement of SUI in relationship with their pre-operative condition on PGI-I.

Conclusions: Patient perceived improvement of incontinence 10 years after a TOT anti incontinence procedure can be as high as 67.2%. The rate of none to mild incontinence symptoms as measured with PGIS-S in this cohort of patients with stress and mixed urinary incontinence was 23.3%. These results can be considered a favourable postoperative outcome of TOT procedure in the long-term.

References:

  1. Int Urogynecol J 2016; 27:19-28.
  2. Int Urogynecol J 2008; 19: 243.
  3. Obstet Gynecol 2008; 112: 1253-1261.

Disclosure:

Work supported by industry: no.

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