Still safe and successful? Longterm results of 100 consecutive transobturator tapes
BAUS ePoster online library. Croghan S.
Jun 26, 2018; 211330
Ms. Stefanie Croghan
Ms. Stefanie Croghan
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Abstract
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Introduction: Whilst the transobturator tape (TOT) has demonstrated good results at short term follow-up, a lack of longterm outcome data is recognised. We aimed to assess longterm outcomes of TOTs, and ascertain whether preoperative urodynamics predicted outcome.

Patients & Methods: A retrospective review of 100 TOTs inserted for stress/mixed UI over a 5-year period was performed. A single surgeon assessed and operated on all patients. Pre-operative investigations (uroflow,cystometrogram,cystoscopy & stress test) and post-procedure urodynamics were recorded. Patients (now >7 years post-procedure) were posted ICIQ Short-Form, PGI-S and PGI-I questionnaires for completion. Complications were recorded.

Results: 100 patients were included, mean age 51.7 years (33-75), mean follow-up 9.25 years (7.5 - 12.75). Clinically, 68/100 had mixed-UI. 32/100 had clinical pure SUI, with CMG detrusor overactivity in 8/32(25%). Clinical and urodynamic cure/significant improvement in SUI was seen in 98/100 and 93/100 respectively. 50/68(73.53%) mixed-UI patients reported cure/improvement of urge incontinence at 2 months. De-novo clinical urgency/detrusor instability arose in 2/100. Of contactable patients, questionnaire response rate was 60/85(70.59%). Mean ICIQ score was 8.58(1-20). 52/60(86.67%) described current urinary condition as “much better” or “very much better” than prior to surgery. Grade 3b Clavien-Dindo complications occurred in 9/100; all apparent within 6 months of surgery. Correlations (Pearson r) between pDetQMax and post-operative uroflow/duration ISC, or between preoperative leak-point pressures and outcome were not significant.

Conclusions: TOTs demonstrate high success rates in urodynamic and patient reported cure of stress/mixed-UI, with a low complication rate at longterm follow-up. Recent controversies surrounding use of pelvic mesh make this data particularly pertinent.
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