Transobturator vaginal tape (inside-out) for stress urinary incontinence after radical cystectomy and orthotopic reconstruction in women

Abdelbasset A Badawy; Mohamed D Saleem; Ahmad Abolyosr; Abdelmoneim M Abuzeid

doi:10.1016/j.aju.2012.02.010

Transobturator vaginal tape (inside-out) for stress urinary incontinence after radical cystectomy and orthotopic reconstruction in women

Arab J Urol. 2012 Jun;10(2):182-5. doi: 10.1016/j.aju.2012.02.010. Epub 2012 Apr 21.

Authors

Abdelbasset A Badawy¹, Mohamed D Saleem¹, Ahmad Abolyosr², Abdelmoneim M Abuzeid¹

Affiliations

¹ Urology Department, Sohag Faculty of Medicine, Sohag, Egypt.
² Urology Department, Qena University Hospital, South Valley University, Qena, Egypt.

Abstract

Objectives: To evaluate the safety and clinical efficacy of the transobturator vaginal tape 'inside-out' (TVT-O) procedure for managing new-onset stress urinary incontinence (SUI) after radical cystectomy (RC) and orthotopic W-neobladder construction in women.

Patients and methods: Between January 2004 and June 2010, 57 women were treated with RC and orthotopic ileal neobladder reconstruction. Six of these patients (median age 44 years, range 39-62; grade 2 muscle-invasive squamous cell carcinoma in four and transitional cell carcinoma in two) developed de novo SUI that was moderate in four and severe in two. The median (range) duration of SUI was 11 (9-18) months. All six patients underwent TVT-O for control of their SUI.

Results: Four patients were completely dry day and night (three of them can initiate voiding and one cannot, and uses intermittent catheterization). One patient improved, as assessed by using fewer pads (from 5-7 pads to 1 pad/day and night). She can initiate voiding but has minimal leakage only on moderate exertion. One patient who had severe SUI showed no improvement. Patients were followed for a mean (range) of 18 (17-32) months, with no deterioration in the continence status.

Conclusion: These encouraging results confirm the safety and clinical efficacy of TVT-O for managing new-onset SUI after RC and ileal neobladder construction, although a larger survey and a longer follow-up are needed.

Keywords: CIC, clean intermittent self-catheterisation; Outcome; PVR, post-void residual urine volume; RC, radical cystectomy; SUI, stress urinary incontinence; Stress urinary incontinence; TVT(-O), tension-free vaginal tape (inside-out); Transobturator vaginal tape; Women.