Transobturatory Tape (ToT) for the Treatment Of Stress Urinary Incontinence: Our Experience and Follow-Up Results

Corresponding Author: Selcuk Sarikaya, Gulhane Research and Training Hospital, Department of Urology, General Tevfik Saglam Caddesi, Etlik– Ankara / Turkey, Tel: +905316274819; Email: [email protected]

Received Date: 17 Oct 2017  Accepted Date: 23 Oct 2017  Published Date: 24 Oct 2017

Copyright © 2017 Sarikaya S

Citation:Sarikaya S, Ciftci M, Senocak C, Ozbek R, et all. (2017). Transobturatory Tape (ToT) for the Treatment Of Stress Urinary Incontinence: Our Experience and Follow-Up Results. Mathews J Urol Nephrol 1(1): 006.

ABSTRACT

Introduction: In this study we aimed to review the results of transobturator tape(TOT) operations retrospectively

Materials and Methods:The datas of 77 patients that were performed transobturator tape between March 2007 and July 2014 according to the diagnose of stress urinary incontinance. Voiding diary for at least 3 days were planned for the patients after history taking. Also urinalysis, urinary system ultrasonography, urodynamic study, physical examination, Q-type test 2-hours ped test were performed fort he patients.

Results:The mean age of the patients was 51,1(34-74). Mean postoperative hospital stay was 1,1(1-2). Patients without complaints were discharged on postoperative first day after the vaginal tampons and urethral catheters were taken. On postoperative third month, complaints of 55 (71,4%) patients were regressed completely. For 13 (16.9%) patients there were significantly improvements. There were no improvements for 3(3,9%) patients. There were urgency and urge incontinance complaints for 6(7,8%) patients after the surgery. There were no major complications or obturator vessel injuries.

Conclusion:Transobturator tape operation is a safe and effective method that is used for the treatment of stress urinary incontinance with higher success and patients satisfaction rates.

INTRODUCTION

Urinary incontinence is mainly involuntary urine leakage that has different subtypes that present with several different symptoms and are treated with different approaches [1]. Urge incontinence usually present with urinary urgency and needs for medical treatment. Anticholinergic drugs are main treatment options for urge type incontinence. Also neurologic functions and the brain factor has an important role in pathogenesis [2]. Stress urinary incontinence is the involuntary leakage with the increase of pelvic pressure for example physical exercise, coughing, sneezing etc [1]. There are medical and surgical approaches for the treatment of stress urinary incontinence. Transobturatory tape (TOT) is a widely-used surgical method for the treatment and the main way for providing continence is kinking mid urethra [3]. Transobturatory tape operation would cause postoperative mild or moderate complications that would cause patient complaints. In this study we aimed to review the postoperative results of transobturator tape (TOT) operations retrospectively

MATERIALS AND METHODS

The datas of 77 patients that were performed transobturator tape between March 2007 and July 2014 according to the diagnose of stress urinary incontinance. Voiding diary for at least 3 days were planned for the patients after history taking. Also urinalysis, urinary system ultrasonography, urodynamic study, physical examination, Q-type test 2-hours ped test were performed for the patients.

RESULTS

The number of patients included in the study was 77. The patients were female and had stress type urinary incontinence.The mean age of the patients was 51,1(34-74). Mean postoperative hospital stay was 1,1(1-2). Patients were treated surgically with transobturatory tape. There was not any peroperative complications. Spinal anesthesia was used for thepatients. Patients without complaints were discharged on postoperative first day after the vaginal tampons and urethral catheters were taken. On postoperative third month, complaints of 55 (71,4%) patients were regressed completely. For 13 (16.9%) patients there were significantly improvements.There were no improvements for 3 (3,9%) patients. Therewere urgency and urge incontinance complaints for 6 (7,8%)patients after the surgery. There were no major complications or obturator vessel injuries.

DISCUSSION

Transobturatory tape(TOT) operation is an effective surgical treatment of stress urinary incontinence. There are studies reported in the literature for comparison of different surgical options. De Guerke et al. compared tension-free vaginal tape(TVT) and transobturatory tape and found similar satisfaction results for both options but more bladder risk for tension-free vaginal tape [4]. El-Hefnawy conducted a similar study with 40 patients [5]. They found that TOT is inferior to TVT when comparing the efficacy but there is less complication rate for TOT [5]. Wang et al. reported the results for 140 patients and they found similar efficacy and safety for both operations [6]. Conversely Torres Zambrano et al. found that urgency was more frequent for TVT [7]. Bandarian et al. compared TOT and burch operations and they found that TOT is a safe procedure with less operation durations [8].

CONCLUSION:Transobturator tape operation is a safe and effective method that is used for the treatment of stress urinary incontinance with higher success and patients satisfaction rates.

REFERENCES

1. Dwyer PL. (2004). Differentiating stress urinary incontinence from urge urinary incontinence. Int J Gynaecol Obstet.86 Suppl 1: S17-24.
2. Morris CL. (2013). Urge urinary incontinence and the brain factor. Neurourol Urodyn. 32(5): 441-448.
3. Juma S and Brito CG. (2007). Transobturator tape (TOT): Two years follow-up. Neurourol Urodyn. 26(1): 37-41.
4. de Guerke L. (2009). [Comparison between TVT and TOT].Gynecol Obstet Fertil. 37(2): 205-207.
5. El-Hefnawy AS, Wadie BS, El Mekresh M, Nabeeh A, at all.(2010). TOT for treatment of stress urinary incontinence:how should we assess its equivalence with TVT? Int Urogynecol J. 21(8): 947-953.
6. Wang F, Song Y and Huang H. (2010). Prospective randomized trial of TVT and TOT as primary treatment for female stress urinary incontinence with or without pelvic organ prolapse in Southeast China. Arch Gynecol Obstet.281(2): 279-286.
7. Torres Zambrano G, Lujan Galan M, Martin Garcia C, Garcia Tello A, et al. (2008). [TVT and TOT for surgical correction of female stress urinary incontinence. Comparison between techniques]. Arch Esp Urol. 61(8): 861-865.
8. Bandarian M, Ghanbari Z and Asgari A. (2011). Comparison of transobturator tape (TOT) vs Burch method in treatment of stress urinary incontinence. J Obstet Gynaecol.31(6): 518-520.