Abstract
To evaluate the long-term subjective cure rate of the transobturator sling, including an analysis of the risk factors and of the impact of increased surgical experience on the results. A retrospective cohort study of women who underwent transobturator sling surgery from 2005 to 2011 was conducted. Patients were evaluated by a telephone survey using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and by subjective questions regarding satisfaction. An ICIQ-SF score of 0 was considered a cure. The crude and adjusted odds ratios and 95% confidence intervals were estimated in univariate and multivariate logistic regression models to identify risk factors for surgical failure. Differences with p < 0.05 were considered significant. In total, 152 (70.6%) patients answered the questionnaire. The median follow-up period was 87 months. The urodynamic diagnosis was stress urinary incontinence in 144 patients (94.7%), and mixed urinary incontinence in 8 (5.3%) patients. Complications occurred in 25 (16%) patients. The ICQ-SF results indicated that 99 (65.10%) patients could be considered cured (ICIQ-SF score = 0). Regarding the degree of satisfaction, 101 (66%) considered themselves cured, 43 (28%) considered themselves improved, 7 (4.6%) considered themselves unchanged, and one reported worsening of the incontinence. After the univariate and multivariate analyses, the primary risk factor for surgical failure was the presence of urgency (p < 0.001). The transobturator sling is effective, with a low rate of complications and a high long-term satisfaction rate. The risk factors for failure were the presence of urgency and patient age. The increased experience of the surgeon was not a factor that influenced the rate of complications.
Highlights
Urinary incontinence (UI) is a frequent condition in the female population, and, it is considered benign, the symptoms impact women socially, physically, and psychologically.[1]
Surgical treatment should be offered to patients with stress urinary incontinence (SUI) or mixed urinary incontinence (MUI) who have not improved with the conservative treatment.[2]
Consistent long-term results indicate the effectiveness of tension-free vaginal tape (TVT) and of transobturator tape (TOT) for the midurethral slings (MUS) procedure.[5,6]
Summary
Urinary incontinence (UI) is a frequent condition in the female population, and, it is considered benign, the symptoms impact women socially, physically, and psychologically.[1]. The TOT can be outside-in or inside-out, with no difference in cure rates between them. Subjective cure rates ranged from 43 to 92% in the transobturator route (TOR) group, and from 51 to 88% in the retropubic route (RPR) group.[1] There is some evidence that it is effective in the long term, but more long-term data are needed to clarify the uncertainties regarding the adverse effects and efficacy of the TOT.[7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
