Genuine Stress Urinary Incontinence Research Articles

Comparative study of two techniques of laparoscopic burch colposuspension using sutures versus mesh in women with genuine stress urinary incontinence

ABSTRACT Background To compare the effectiveness and safety of laparoscopic colposuspension using sutures (LCS) versus mesh and staples (LCM) in the treatment of female stress urinary incontinence. Methods This randomized study was conducted over a total of 80 women with genuine stress urinary incontinence between January 2020 and April 2022. Women were randomly assigned to the LCS group (n = 40) or the LCM group (n = 40). They underwent objective evaluations, including a standardized stress test, a 24-hour pad test, and a frequency-volume chart. Subjective assessments were made using a quality-of-life questionnaire. Results The LCS group exhibited superior outcomes in PAD test improvement (from 147 [31–304] to 3 [0–300] at 1 year, p < 0.001), stress test scores (from 82 [11–153] to 1 [0–124] at 1 year, p < 0.001), and mean micturated volume (increase from 294 ± 65 to 321 ± 57 at 1 year, p = 0.037) compared to the LCM group. Urodynamic findings revealed a higher Maximum Urethral Closure Pressure in the LCS group (33.1 ± 6.9) versus the LCM group (28.3 ± 6.4, p = 0.002). Quality of life improvements were significantly better in the LCS group across various domains. However, the LCM group benefitted from shorter surgery duration, hospital stays, and bladder drainage duration. Conclusion LCS demonstrates significant advantages over LCM in treating female stress urinary incontinence, particularly in cure rates and quality of life improvements. Despite the operational benefits of LCM in terms of reduced surgery and recovery times, LCS offers superior therapeutic outcomes.

Could pelvic floor sonography be a standalone method for excluding genuine stress urinary incontinence in women?

Determine whether introital pelvic floor sonography with transvaginal probe (PFS-TV) can be an independent method in the diagnosis of genuine stress urinary incontinence (SUI) and to create a ultrasonographic diagnostic model to objectify diagnostic process. The study involved 315 patients with a history of urinary incontinence problems. Based on the clinical examination and urodynamic examination, the final diagnosis was made. Patients were divided into two groups. Group I included women with SUI and Group II included patients without SUI (OAB and no-UI). Each patient underwent PFS-TV at rest and during straining. The groups were compared in terms of ultrasound parameters. Patients from both groups differed statistically in a significant way (p < 0.05) in terms of mean distance between the lower edge of the pubic symphysis at rest 19 mm vs 22 mm (Group I vs Group II) and during straining (D1 and D2) 22 mm vs 26 mm, the average value of the γ angle (at rest (γ1) 37.5° vs 40° and during straining (γ2) and 66° vs 58.5°, average difference value of angle γ during straining and at rest (γ2-γ1) 29° vs 14°, and frequency of urethral funneling 89% vs 17%. Two parameters studied during PFS-TV were included in the logistic regression model used to exclude the stress component of urinary incontinence. Diagnostic test parameters of model were sensitivity 86.6%, specificity 90.4%, accuracy 93.1%. PFS-TV makes it possible to exclude the stress component of urinary incontinence. The developed logistic regression model allows for the objectification of the results of ultrasound examination in patients with urinary incontinence.

Young-Dees bladder neck reconstruction: An effective alternative in the treatment of urinary incontinence following urethroplasty for pelvic fracture urethral injury

Introduction: We review our experience of Young-Dees bladder neck reconstruction (BNR) in treatment of urinary incontinence following anastomotic urethroplasty for pelvic fracture urethral injury (PFUI). Material and methods: Between January 2009 and June 2015, 11 patients presented with urinary incontinence following urethroplasty for PFUI. After evaluation with voiding cystourethrogram, urodynamics and cystoscopy, seven were found to be having genuine stress urinary incontinence. All seven underwent Young-Dees BNR. We also looked at whether there were any predictors of either poor or good outcome following surgical correction based on radiographic, endoscopic and urodynamic findings. Results: Of the seven patients who had undergone Young-Dees BNR, four had urethroplasty at our centre (4/89, 4.4%). Median age was 23 years (range = 14–31 years), and median time to definitive treatment was 15 months (range = 9–126 months). Age at injury &lt;15 years in two and &gt;15 years in five. Four (56%) had pubic diastases, in three, it was secondary to the injury, and in one, it was consequent to facilitating urethroplasty via a formal transpubic approach. There were no consistent radiographic findings on the pre-operative studies which could predict whether the configuration of the bladder neck or the degree of bladder descent might result in incontinence. The number of prior attempts at urethroplasty when compared to a similar cohort was also non-contributory. At urodynamics, all bladders were stable on filling and there were no issues related to compliance with the bladder neck being occluded. The detrusor pressure generated during voiding and with the bladder neck occluded did help us to counsel patients regarding the outcome of surgery and if there would be a need for clean intermittent self-catheterisation following surgery. All patients are voiding via naturalis without the need for clean intermittent self-catheterisation and are socially continent. Conclusion: Young-Dees BNR may be a forgotten procedure but is worth revisiting in patients with stress urinary incontinence following successful urethroplasty for PFUI. It is cost-effective and can be done without the Leadbetter modification. Level of evidence: Not applicable

Urethral Bulking in the Treatment of Stress and Mixed Female Urinary Incontinence: Results from a Multicenter Cohort and Predictors of Clinical Outcomes.

The aim of the present study is to analyze the outcomes of urethral bulking in the treatment of non-neurogenic female stress and mixed urinary incontinence and to assess predictors of clinical outcomes. We retrospectively included all consecutive patients affected by stress or mixed urinary incontinence and treated with urethral bulking. Outcomes were evaluated via the PGI-I questionnaire and the 24-h pad test. Between January 2010 and January 2020, we treated 216 patients (Bulkamid n = 206; Macro-plastique n = 10). The median age at surgery was 66 years (IQR 55–73.75). The median follow-up was 12 months (IQR 12–24). In total, 23.8% of patients were subjected to prior incontinence surgery, 63.8% of patients were affected by genuine stress urinary incontinence, 36.2% reported mixed urinary incontinence, whereas detrusor overactivity was confirmed in only 24.9%. The dry rate was 32.9%; nevertheless, 69.9% of patients declared themselves “very improved” or “improved” (PGI-I1-2). Low complications were observed, mostly classified as Clavien I. After univariate and multivariate analyses, the only statistically significant independent predictor of “dry” outcome was the 24 h pad test, p < 0.001. Urethral bulking could be proposed with more expectations of success in patients with mild urinary incontinence. Patients affected by moderate–severe incontinence are less likely to obtain clinical success; therefore, they should be carefully counselled about clinical expectations before the procedure.

Effectiveness and the quality of life following laparoscopic Burch colposuspension for genuine urinary stress incontinence: six and twelve months follow up

Overview: Burch colposuspension is introduced in 1961 and since then it has been the gold standard treatment modality for genuine urinary stress incontinence. Methods: In this prospective cross-sectional study we have analyzed data from 36 women aged 42 to 63 years who had undergone laparoscopic Burch colposuspension at Colombo South Teaching Hospital Sri Lanka during the period from 2012 to 2021. Patients completed a self-administered Short Urinary Distress Inventory (SUDI) and Short Incontinence Impact Questionnaire (SIIQ) at both the baseline and the post-operative follow up (6 months, 12 months) period. The Genito-Urinary Treatment Satisfaction Scale (GUTSS) was utilized to assess satisfaction with the outcomes of the laparoscopic repair surgery. Results: Six months following the surgery, Stress Urinary Incontinence (SUI) was 9.38% with p=0.38, SUI and/or urge incontinence was 18.75% with p=0.56, which were statistically not significant. In both analyses of SUDI and SIIQ there were significant improvements in outcomes. Satisfaction with treatment outcomes from the GUTSS at six months follow up was 32.5 ± 5.8 with p=0.48. At 12 months following surgery, 15.6% of patients had GSI while 9.38% had stress incontinence frequently (p=0.26). Conclusion: Laparoscopic Burch colposuspension is an effective technique and treatment modality for urinary stress incontinence. Both objective and subjective evaluation of surgical outcomes at 6 and 12 months of follow-up demonstrated significant improvement and repetitive corrective surgeries are uncommon.

Assessment of Correction of Female Stress Urinary Incontinence with Trans Obturator Tape; Traditional versus Tailored

Abstract Background: Female genuine stress urinary incontinence (SUI) affects a great number of females, with important social and economic consequences. SUI is more frequent after several deliveries, after menopause as a result of changes in the urethral support or the sphincter mechanism. Aim of Study: To compare traditional tension free trans-obturator tape (TOT) and surgeon tailored mesh (STM) in treatment of female stress urinary incontinence as regard of safety, efficacy, side effects, cost, and follow-up. Patients and Method: Prospective randomized study was done on sixty three female patients were suffered SUI with determining of eligibility of the study as shown in COSORT flow chart Fig. (1) at Al Zahraa University Hospital, Al Azhar University from December 2016 to April 2019. All patients subjected to full history, general, and local examination (cases of cystocele, rectocele, or previous vaginal surgeries were excluded). Cystometrogram (CMG) was done for exclusion of uninhibited detrusor contractions, small bladder capacity ( 100 CC) assessed by ultrasonography were excluded from this study. All patients requested surgical treatment and provided informed written consent, and the study was approved by the ethical committee. With follow-up for six month post-operatively. Results: Depending on subjective criteria obtained from the Patric questionnaire, and objective criteria from physical examination.As regards traditional tape group, 13 patients (43.33%) were cured; two patients (6.67%) improved with no failed cases and STM group 14 patients (46.67%) were cured; one patient (3.33 %) improved with no failed cases (p-value 0.542, Pearson Chi-Square test). Conclusions: TOT (outside in technique) using both STM and traditional tape are minimally invasive techniques and are equally effective and safe in treatment of pure female SUI, with short hospital stay which reduces the cost of surgery. Both techniques could be used in treatment of pure SUI with good outcome. This technique is more economical due to the cheap ordinary polypropylene mesh. So, it should be considered as a low-cost alternative to the available commercial kits in the treatment of female SUI, mainly for public health systems with few financial resources.

A Novel Artificial Urinary Sphincter (VICTO®) for the Management of Postprostatectomy Urinary Incontinence: Description of the Surgical Technique and Preliminary Results from a Multicenter Series

Aims: The objective of the study was to analyze short-term outcomes and safety profile of the newly designed artificial urinary sphincters (AUSs) VICTO® and VICTOplus®. Methods: Data from the implant of VICTO® or VICTOplus® AUSs on a series of consecutive male patients with stress urinary incontinence (SUI) following radical prostatectomy (RP) were retrospectively collected in 3 tertiary referral centers between May 2017 and December 2019. Patients were affected by moderate-severe genuine SUI (200–400 or >400 g urine leakage in 24-h pad test) refractory to conservative treatment. Outcomes were evaluated through the 24-h pad test and the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF). Follow-up was scheduled after 3, 6, and 12 months and then when clinically needed. Nonparametric tests were applied in subgroup analyses. Results: Seventeen patients were enrolled: 8 were implanted with the VICTO® device and 9 with VICTOplus®. The median age at surgery was 69 (interquartile range (IQR) 60–75) years. The median follow-up was 15 (IQR 12–18) months. At 12 months, the dry rate was 76.4% and the social continence rate was 94%. The postoperative complication rate was 17.6%. All complications were classified as Clavien-Dindo I. No difference in terms of outcomes was observed between the VICTO® and the VICTOplus® subgroups. Conclusions: Preliminary outcomes of the VICTO® and VICTOplus® implantation are satisfactory. These devices may represent a safe and realistic solution for patients with moderate-severe SUI following RP.

Evaluation of Upright Magnetic Resonance Imaging in Female Genuine Stress Urinary Incontinence before and after MonarcR Bladder Neck Suspension: A Prospective Cohort Study

Evaluation of Upright Magnetic Resonance Imaging in Female Genuine Stress Urinary Incontinence before and after MonarcR Bladder Neck Suspension: A Prospective Cohort Study

Evaluation of transperineal ultrasound in diagnosis and grading of female genuine urinary stress incontinence

Stress urinary incontinence (SUI) has an observed prevalence of between 4%and 35%. Purpose: To determine the role of transperineal ultrasound in diagnosing stress incontinence, its degree and the possible cause by: Measuring the BN descent, urethral hypermobility, funneling of BN or proximal urethra, urethral diameter, posterior urethra vesical angle, associated cystocele Using color Doppler to detect escape of urine through the urethra. Methods: 52 female patients diagnosed to have genuine stress incontinence using 3 day voiding diary, simple questionnaire and confirmed by standard urodynamics. Classification of stress incontinence into mild, moderate and severe using Valsalva leak point pressure during urodynamic study. Transperineal ultrasound for evaluation of the anterior pelvic compartment regarding: bladder neck descent, urethralhy permobility, Funneling of the BN, posterior urethrovesical angle ,urethral diameter, associatedcystocele, and finally the Doppler detection of urinary escape both at rest and with Valsalva maneuvers. Results: 28/52 cases (53.8%) of SUI didn’t show clinical evidence of cystocele; 11 cases (21.2%) showed grade 1 cystocele and 13cases (25%) showed grade 2 cystocele. The presence or absence of cystocele and also the grade of cystocele did not show a statistically significant relation to the degree of SUI; p=0.089 and 0.086 respectively Conclusion: We came to conclusion that transperineal ultrasound can be used in accurate diagnosis and grading of female urinary stress incontinence with our given cutoff values for bladder displacement, α angle, β angle and urethral diameters and from this grading by transperineal ultrasound comes the novelity of our research.

Urethral Diverticulum Excision and Placement of Autologous Fascia Lata Sling

Video Objective To show the repair of an uncommon urogynecological pathology, and to illustrate a case where an autologous fascial graft is placed for management of stress urinary incontinence. Setting The patient is a 59-year-old with abdominal pain, urinary incontinence, incomplete bladder emptying, and hematuria. She has a complex past medical and surgical history. Pre-operative urodynamic testing showed genuine stress urinary incontinence, and office cystoscopy was unremarkable. Imaging demonstrated a urethral diverticulum containing multiple stones. The patient proceeded to the operating room for excision of the diverticulum and placement of an autologous sling. Interventions Fascia lata from patient's right thigh was harvested and prepared with polypropylene sutures at each end. Cystourethroscopy identified the diverticulum opening in the posterior mid urethra. The anterior vaginal mucosa was incised and the pubocervical fascia was dissected. The bulge of the urethral diverticulum was identified. Entry into the diverticulum was encountered during the dissection, and multiple stones were removed. The entire diverticular sac was dissected from the posterior urethra and pubocervical fascia. The urethral wall was reapproximated. The periurethral fibromuscularis was closed in a vest-over-pants fashion in order to avoid overlapping suture line with the urethral closure. An abdominal incision was made above the pubic symphysis. Needle trocars were passed vaginally through retropubic space. The polypropylene stitches on the fascial lata graft were threaded through the needles and pulled onto the abdomen, placing the sling in place. The sutures were then sewn through the rectus fascia and tied in the midline. Final cystourethroscopy confirmed patent ureteral orifices, normal bladder mucosa, and intact urethral repair. A Foley catheter was replaced and maintained for 4 weeks. A voiding cystogram showed intact bladder and urethra. Conclusion This case depicts a scenario where autologous sling is preferable over synthetic mesh due to decreased risk of erosion when a urethral diverticulum is repaired.

Minimally Invasive Burch Colposuspension - The Robotic Approach

Video Objective To demonstrate a minimally invasive technique to the Burch procedure for treatment of stress urinary incontinence as an alternative therapeutic modality for women who do not want or cannot have mesh products. Setting Surgical intervention for a 68 yo G12 P10-0-2-10 with prolapse and stress urinary incontinence (SUI). After undergoing appropriate counseling and discussion regarding risks, benefits and alternatives the patient and family declined use of mesh products for any portion of the repair. The decision was made to proceed with a hysterectomy, uterosacral colpopexy and Burch colposuspension. Preoperative optimization of her health and multiple co-morbidities required a multidisciplinary approach. Blood pressure control, diabetes and thyroid management as well as topical estrogen treatment of vaginal epithelium for 3 months prior to surgery. Interventions Robotic colposuspension for genuine SUI following a robotic hysterectomy and uterosacral colpopexy. The procedure took 62 minutes to complete, the blood loss was minimal and there were no complications. She was observed overnight, had a successful voiding trial in the morning and was discharged shortly after. Follow up at 2 and 6 weeks after surgery she reported no pain and no complications. She reports significant improvement in bladder function and bladder control. Conclusion The Burch procedure is well known as an effective treatment for SUI but generally not frequently performed due to morbidity associated with laparotomy requiring procedures and the availability of less invasive approachesmsuch as a transvaginal suburethral sling. With the minimally invasive surgery evolution being inclusive of nearly all gynecologic procedures, a robotic or laparoscopic Burch colposuspension as an alternative to transvaginal suburethral sling with mesh should be considered. This videos demonstrates a reproducible, safe and efficient approach to this procedure.

The challenge of complex wound healing caused by necrotizing fasciitis after infection of tension-free vaginal transobturator tape (TVT-O) incontinence material

Pelvic organ prolapse with or without stress urinary incontinence (SUI) is a common gynecological condition that occurs predominantly in middle and old age. Tension-free vaginal tape (TVT) technique is a surgical procedure for treatment of female SUI that is used worldwide. Severe complications are extremely rare. The authors present treatment methods with which they have successfully used for such cases. The Ljubljana University Medical Center carried out 2,587 TVT operations for genuine SUI between 1998 and 2017. The authors carried out a retrospective study to determine long-term success. However, in all of these years, they treated only two serious complications involving necrotizing fasciitis. Both patients were 61-years old, the first patient suffered necrotizing fasciitis shortly after her transobturator TVT (TVT-O) procedure, and the second six years after the initial surgery. Both of them had had repeated extensive fasciectomy, soft tissue debridement, and various modern wound dressing changes, and one of them had had negative pressure wound therapy. Severe complications of TVT-O are rare but present a possibility for great morbidity and mortality. Early surgical treatment plays an important role, together with additional medication.

The role of transobturaor vaginal tape (TOT) in the management of female stress urinary incontinence - 2 year follow up, Minia University experience

Objective: The aim of this study was to evaluate the effectiveness and safety of minimally invasive surgical procedure trans-obturator vaginal tape (TOT) in the treatment of female stress urinary incontinence and follow up these cases for 24 months regarding effectiveness, safety and possibility of complications. PATIENTS: 30 women with genuine stress urinary incontinence (SUI) demonstrated by history, clinical examination and urodynamic study. METHODS: 30 patients diagnosed with SUI underwent transobturator sling (inside-out technique) (TVT-O Gynecare ®, Johnson& Johnson, USA.) The patients were followed up for 24 - months regarding subjective and objective cure rates. RESULTS: The mean operative time (min.) was 19.67 (±8.06). The mean intraoperative blood loss (ml) was 80±30.52. There was no case complicated by intraoperative bleeding (mild or severe), bladder, urethral, vascular injuries and anesthetic complications. Subjective and objective cure rates of these patients were (95%) both. Conclusion: The results of this study concluded that management of genuine stress urinary incontinence by transobturator vaginal tape (TVT-O) is an easy and safe method with low complications and high success rate.

Assessment of the Quality of Life in Patients with Genuine Stress Urinary Incontinence Treated by Tension-free Vaginal Tape

Assessment of the Quality of Life in Patients with Genuine Stress Urinary Incontinence Treated by Tension-free Vaginal Tape

The role of trans-obturator vaginal tape (TVT-O) in the management of female stress urinary incontinence: 2 years follow up, Minia University Experience

Objective: The aim of this study was to evaluate the effectiveness and safety of a new minimally invasive surgical procedure, trans-obturator vaginal tape (TVT-O), in the treatment of female stress urinary incontinence and following-up these cases for 24 months regarding effectiveness, safety and possibility of complications.Type of the Study: with a 24 -months follow-up.Setting: Department of Obstetrics and Gynecology, Faculty of Medicine, Minia University, Minia, Egypt.Patients: Thirty women with genuine stress urinary incontinence (SUI) demonstrated by history, clinical examination and urodynamic study.Methods: Thirty patients diagnosed with SUI underwent trans-obturator sling (inside-out technique) (TVT-O Gynecare®, Johnsonand Johnson, USA.).Outcome Measures: The patients were followed up for 24 - months regarding subjective and objective cure rates.Results: The mean operative time (min.) was 19.67 (±8.06). The mean intraoperative blood loss (ml) was 80 ± 30.52. There were no cases complicated with intraoperative bleeding (mild or severe), bladder, urethral, vascular injuries and anesthetic complications. Subjective and objective cure rates of these patients were (95%).Conclusion: The results of this study concluded that management of genuine stress urinary incontinence by trans-obturator vaginal tape (TVT-O) is an easy and safe method with low complications and high success rate.

The Outpatient Burch-Sling Procedure: A Nerve-Sparing Method for Correcting Female Urinary Incontinence

Conventional methods to treat urinary stress incontinence, including the Sling, Burch, and Pereyra modification methods, are limited by several shortcomings due to disrupted nerve and vaginal wall integrity. The nerve-sparing Burch-Sling method represents a surgical advancement through the use of a nerve-sparing sling to treat genuine stress urinary incontinence. The procedure involves retropubic urethropexy using the FDA-approved Burch-Sling device. In this technique, the vagina is elevated bilaterally at the urethrovesical junction to the mid-urethra toward Cooper’s ligament above the base of the bladder. Then, the anterior vaginal wall and fascia are used as an endogenous suburethral sling without dissection. Two hundred twenty cases were included in this study; two hundred patients underwent the outpatient nerve-sparing sling method, and the other twenty underwent the novel abdominal Burch method. There were no major complications. The follow-up duration ranged from 6 months to eight years. All procedures were performed at the U.S. Women’s Institute at a 400-bed hospital in Fountain Valley, CA.

Tension-free Vaginal Tape vs Tension-free Obturator Tape for Treatment of Genuine Stress Urinary Incontinence: A 5-year Follow-up

ABSTRACT Objective To compare the effectiveness of tension-free vaginal tape (TVT) and tension-free obturator tape (TOT) in treatment of genuine stress urinary incontinence and study the related complications. Materials and methods About 150 cases with complaints of stress urinary incontinence were taken during 5-year period, and they were confirmed urodynamically. Exclusion criteria included patients with diabetes mellitus, neurological disorders, other forms of incontinence, uterovaginal prolapse, urinary tract infection, and pregnancy. Out of 150 cases, 70 underwent TVT procedure and 80 were taken up for TOT. The outcome was studied at the end of 5 years. Results The cure rate in the TOT group was 94%, which was slightly higher than the TVT group, which came out to be 90%. The failure rate in the TVT group was 1.1%, but no failure was encountered in the TOT group. However, the improvement rates were similar in each group. Comparing the complications in each group, the rate of bladder perforation and postoperative retention of urine was much higher in the TVT group. Postoperative voiding difficulties were also noticeably less in TOT group compared with TVT group. However, none of the cases in either group had de novo urgency. Conclusion Both the procedures are a safe and effective method of curing stress incontinence; however, owing to slightly higher improvement rates and lower complications rate, TOT should be preferred over TVT. How to cite this article Bhadana P, Mittal P, Bachani S. Tension-free Vaginal Tape vs Tension-free Obturator Tape for Treatment of Genuine Stress Urinary Incontinence: A 5-year Follow-up. J South Asian Feder Obst Gynae 2017;9(2):89-93.

Burch Retropubic Urethropexy for Genuine Stress Urinary Incontinence: A Review of Eight Cases

ABSTRACT Introduction Urinary incontinence (UI) is more common than any other chronic disease with the prevalence of approximately 23 and 55%. Among the various forms of UI, stress incontinence (SUI) is the most common (49%), with urgency incontinence (UUI) representing 21% and mixed type (MUI) at 29%. As it affects the quality-of-life of women, the restoration of urinary continence is one of the greatest challenges. Aim To review the cases of genuine SUI treated surgically by Burch retropubic urethropexy. Results We have managed surgically eight cases of genuine SUI by Burch retropubic urethropexy. On 1-year follow-up, none of the patients had any urinary complaints. All had responded well to surgery and patient's satisfaction index was good. Conclusion Since SUI is the commonest among incontinences, it is a challenge to diagnose and treat to improve quality-of-life of patients. Burch retropubic urethropexy is the gold standard treatment for SUI, especially if other indications exist for abdominal surgery. Even in the present era of less invasive vaginal procedures, results are comparable. How to cite this article Rajput DA, Valecha SM, Sarwade M, Dhumale S. Burch Retropubic Urethropexy for Genuine Stress Urinary Incontinence: A Review of Eight Cases. J South Asian Feder Menopause Soc 2017;5(2):129-132.

Suburethral sling

ObjectiveThe aim of the study was to produce and evaluate a new technique using a small-fashioned prolene tape to treat female genuine stress incontinence.Patients and methodsA total of 120 (n=120) female patients with genuine stress urinary incontinence were subjected to history taking, physical ex

Influence of Demographic and Clinical Factors on Surgical Outcomes of the Transobturator Tape Procedure in Patients with Stress Urinary Incontinence

Background: Stress urinary incontinence (SUI) is a prevalent problem within the female population with associated high psycho-social impact. Transobturator tape procedure is a well-established procedure to treat the same, but the results may be influenced by various preoperative demographic and clinical factors. Patients and Methods: The study group comprised of 50 female patients with genuine SUI, who were then divided into subgroups based on demographic and clinical factors. Outcomes were compared between these subgroups at 6 and 12 months using self-reported questionnaires and provocative stress test. Results: Our results show positive correlation with statistically significant better surgical outcomes in premenopausal patients, patients aged <50 years and those having urethral mobility > 30 degrees. Statistically significant poor outcomes were seen in those having undergone hysterectomy or Caesarean section. No correlation was found with history of smoking or the patient's body mass index. Conclusions: In conclusion, the transobturator tape procedure appears to be more effective in premenopausal women, women aged < 50 years, women without history of hysterectomy/lower section Caesarean section, and presence of urethral hypermobility > 30 degrees. On the other hand, outcomes do not appear to be influenced by the patient's body mass index or smoking status.