Document Detail

Objective cure rates and patient satisfaction after the transobturator tape procedure during 6.5-year follow-up.
MedLine Citation:
PMID:  23312245     Owner:  NLM     Status:  In-Data-Review    
STUDY OBJECTIVE: To report the subjective and objective outcomes and patient satisfaction with the outside-in transobturator tape (TOT) procedure during long-term follow-up.
DESIGN: Clinical follow-up study (Canadian Task Force classification II-2).
SETTING: University hospital.
PATIENTS: One hundred ninety-one women who underwent the TOT procedure. Of these, 66% had stress urinary incontinence and 34% had mixed urinary incontinence, and 45% underwent concomitant surgery.
INTERVENTIONS: Patients underwent surgery between May 2003 and December 2004 using the TOT procedure. After a mean follow-up of 6.5 years, postal questionnaires and an invitation for a follow-up visit to the outpatient clinic were sent to the patients. Objective cure was defined as a negative result of a stress test and no repeat operation because of stress urinary incontinence during follow-up. Subjective outcome was evaluated using the following validated questionnaires: UISS (Urinary Incontinence Severity Score), DIS (Detrussor Instability Score), VAS (visual analog scale, 0-100), short versions of the IIQ-7 (Incontinence Impact Questionnaire-7) and UDI-6 (Urogenital Distress Inventory-6), and the EQ-5D and EQ-5D VAS. Patient satisfaction was evaluated using a self-tailored questionnaire.
MEASUREMENTS AND MAIN RESULTS: Of 191 patients, 139 (73%) were evaluated after a mean follow-up of 6.5 years. Objective and subjective cure rates were 89% and 83%, respectively. Of the patients with genuine stress urinary incontinence, 92% were completely or quite satisfied with the surgery, and 76% of the patients with mixed urinary incontinence were satisfied (p < .001). Patients with body mass index >30 had significantly higher scores on the IIQ-7, UDI-6 (p < .01 for both), VAS (p < .001), UISS (p < .01), and DIS (p < .001), thus indicating a less favorable outcome of the procedure.
CONCLUSION: A high objective cure rate persisted after a mean follow-up of 6.5 years. Caution is advised when the TOT procedure is planned in patients with mixed urinary incontinence or severe obesity.
Pia Heinonen; Seija Ala-Nissilä; Raija Räty; Eija Laurikainen; Pentti Kiilholma
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of minimally invasive gynecology     Volume:  20     ISSN:  1553-4669     ISO Abbreviation:  J Minim Invasive Gynecol     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101235322     Medline TA:  J Minim Invasive Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  73-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 AAGL. Published by Elsevier Inc. All rights reserved.
Department of Obstetrics and Gynecology, Turku University and Salo Regional Hospital, Turku, Finland. Electronic address:
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