Safety and efficacy of the transobturator tape for stress urinary incontinence: short-term and medium-term results of 125 patients demonstrate a procedure-related learning curve

Abstract

Our aim was to assess the safety and efficacy of the transobturator tape (TOT) for the surgical treatment of female stress urinary incontinence. We report our initial experience in a district general hospital and study the learning curve effect. This is a retrospective study of the first 125 women to have the TOT procedure (Aris® Transobturator Tape). Short-term follow-up took place with the operating gynecologist in the clinic 3 months postoperatively, while medium-term follow-up was assessed by a patient questionnaire at 18–36 months (mean 23 months). Short-term success rate was 89.3%. Complications were bladder injury 2.4%, postoperative urinary tract infection 8.1%, transient voiding dysfunction 13.7%, tape erosion 4.1%, and de novo urgency 14%. Questionnaire response rate was 66%. Subjective cure at 18–36 months was 81.5% with 88.9% reporting an improvement in quality of life. Ten women underwent repeat TOT after primary procedure failure with 80% success. Tape erosion occurred up to 17 months postoperatively, thus overall incidence was 6.4%. The incidence of bladder injury, tape erosion, and tape failure was higher in the first 60 patients, thus we performed an analysis of these events by the number of procedures performed and demonstrated a definite learning curve. The TOT is a safe and effective surgical treatment for stress urinary incontinence; however, as for all new surgical procedures, there exists a learning curve.