Transobturator suburethral tape in the treatment of stress urinary incontinence: efficacy and quality of life after 5 year follow up

Abstract

Objectives: Stress urinary incontinence (SUI) is a highly prevalent dysfunction in middle-aged and elderly women. One recent technique places a sub-urethral tape passed through the transobturator foramen. Efficacy and quality of life were assessed after five years of treatment with the transobturator technique in women suffering SUI. This evaluation followed a previous control at the first year post-intervention.

Study design: Sixty-three women were assessed five years after operation with the transobturator technique. Additionally, twenty-nine women of these women had undergone pelvic floor reconstruction due to different forms of genital prolapse. Quality of life (QoL) was assessed by the Urogenital Distress Inventory-6 (UDI-6) and the Incontinence Impact Questionnaire-7 (IIQ-7) tests.

Main outcome measures: Subjective and objective cure or improvement, complications, and changes in QoL.

Results: Fifty women (79%) remained cured, as assessed by the cough test. Eighteen women (28%) reported urine leakage during physical activity. These objective and subjective data were worse than those reported at the one-year follow-up. De novo urge urinary incontinence was reported by 11 women or 17%. Nine of these women had undergone additional pelvic floor surgery. The QoL tests confirmed that cure or improvement was achieved in 78% (49) (UDI-6) and 79% (50) (IIQ-7) of the women.

Conclusions: The transobturator tape procedure resulted in acceptable rates of efficacy after five years. Moreover, QoL tests showed cure or improvement in almost four of five women. Nonetheless, women should be informed of the risk of de novo urinary urgency incontinence and the progressive loss of efficacy with time.