Evaluation Of Transobturator Tension Free Vaginal Tapes In The Management Of Women With Mixed Urinary Incontinence: 1-Year Outcomes

Objectives: To assess the efficacy of transobturator tapes in the management of women with urodynamic mixed urinary incontinence (MUI).
Study Design: A secondary analysis of a prospective randomised study; 83 women with MUI on urodynamics and predominant SUI symptoms were recruited and randomly assigned to undergo “outside-in” or inside-out transobturator tapes. Pre-operative assessment included urodynamic assessment and completion of validated symptom severity and quality of life (QoL) questionnaires. The primary outcome was patient-reported success rates at 1-year as assessed by the PGI-I (Very Much/ Much improved). Secondary outcomes included changes in pre-operative urgency/ urgency incontinence, changes in QoL scores and comparison between the two types of transobturator tapes.
Results: 77 women completed 1-year follow-up (outside-in n=42 vs. inside-out n=35). The patient reported success rate and objective cure rate were 75% and 90% respectively. At 1-year follow-up; 40 women (52%) & 31 women (57.4%) reported cure in their preoperative urgency and urgency incontinence respectively. 74% reported = 10 point improvement in QoL scores.
Conclusion: In women with urodynamic mixed incontinence and predominant SUI, transobturator tapes were associated with good patient-reported success rate at 1 year. Urgency/ urgency incontinence are cured in over 50% of women.