Long-term outcomes for transobturator tension-free vaginal tapes in women with urodynamic mixed urinary incontinence

Mohamed Abdel-Fattah; Gabriel Cao; Alyaa Mostafa

doi:10.1002/nau.23192

Long-term outcomes for transobturator tension-free vaginal tapes in women with urodynamic mixed urinary incontinence

Mohamed Abdel-Fattah, Gabriel Cao, Alyaa Mostafa

University of Aberdeen

Research output: Contribution to journal › Article › peer-review

19 Citations (Scopus)

9 Downloads (Pure)

Abstract

AIMS

To assess the long-term patient reported outcomes following transobturator tension-free vaginal tapes (TO-TVT) in women with urodynamic mixed urinary incontinence (MUI).

METHODS

A secondary analysis of the 9-year follow-up of the E-TOT study: 341 women with predominant stress urinary incontinence symptoms were randomized to undergo either inside-out or outside-in TO-TVT between April 2005 and April 2007. Forty-eight women had preoperative urodynamic MUI and were available for 9-year follow-up. Primary outcome was the patient-reported success rate defined as very/much improved on Patient's Global Impression of Improvement PGI-I. Secondary outcomes included impact on women's quality of life, sexual function, overactive bladder symptoms,and late adverse events. Statistical analysis was performed using SPSS v.23.

RESULTS

Forty-eight women completed the 9-year follow-up, with adjusted response rate of 63%. The success based on the PGI-I was 64.6% (n = 31), with a further 14.6% (n = 7) who reported “improved.” There was no significant difference between groups (OR 1.11; 95%CI 0.33, 3.70; P > 0.999). Clinically significant improvement in quality of life was found in 85.3%. Cure of urgency and UUI was reported by 35% and 41%, whereas worsening was reported in 6.5% and 2.3%, respectively. One patient reported chronic groin/leg pain. The small sample size and the sizeable loss to follow-up are limitations in this study.

CONCLUSIONS

This is the first study to report the long-term outcomes of TO-TVT in women with urodynamic MUI; TO-TVT is associated with a good and sustained patient-reported success rate in women with MUI up to 9-years follow-up.

Original language	English
Pages (from-to)	902-908
Number of pages	7
Journal	Neurourology and Urodynamics
Volume	36
Issue number	4
Early online date	28 Dec 2016
DOIs	https://doi.org/10.1002/nau.23192
Publication status	Published - Apr 2017

Bibliographical note

We thank Dr D. Kramakar (DK) (Research Fellow—University of Aberdeen) for sending out the questionnaires and collating the responses. We thank Lindsey Grant (LG) for performing the independent data entry cross-check. A special gratitude is to all the women whose excellent cooperation made this study successful. The initial phase of this study (up to 3-year follow-up) was funded by the Henry Smith Charity. Dr Karmakar was funded by IUGA Clinical Fellowship Grant 2014.

Keywords

mid-urethral slings
stress urinary incontinence
tension-free vaginal tape
transobturator tapes
urinary incontinence

Access to Document

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Accepted Manuscript
This is the peer reviewed version of the following article: Abdel-Fattah M, Cao G, Mostafa A. Long-term outcomes for transobturator tension-free vaginal tapes in women with urodynamic mixed urinary incontinence. Neurourol Urodynam. 2017; 36:902–908., which has been published in final form at https://doi.org/10.1002/nau.23192. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Accepted author manuscript, 196 KBLicence: Unspecified

Cite this

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title = "Long-term outcomes for transobturator tension-free vaginal tapes in women with urodynamic mixed urinary incontinence",

abstract = "AIMSTo assess the long-term patient reported outcomes following transobturator tension-free vaginal tapes (TO-TVT) in women with urodynamic mixed urinary incontinence (MUI).METHODSA secondary analysis of the 9-year follow-up of the E-TOT study: 341 women with predominant stress urinary incontinence symptoms were randomized to undergo either inside-out or outside-in TO-TVT between April 2005 and April 2007. Forty-eight women had preoperative urodynamic MUI and were available for 9-year follow-up. Primary outcome was the patient-reported success rate defined as very/much improved on Patient's Global Impression of Improvement PGI-I. Secondary outcomes included impact on women's quality of life, sexual function, overactive bladder symptoms,and late adverse events. Statistical analysis was performed using SPSS v.23.RESULTSForty-eight women completed the 9-year follow-up, with adjusted response rate of 63%. The success based on the PGI-I was 64.6% (n = 31), with a further 14.6% (n = 7) who reported “improved.” There was no significant difference between groups (OR 1.11; 95%CI 0.33, 3.70; P > 0.999). Clinically significant improvement in quality of life was found in 85.3%. Cure of urgency and UUI was reported by 35% and 41%, whereas worsening was reported in 6.5% and 2.3%, respectively. One patient reported chronic groin/leg pain. The small sample size and the sizeable loss to follow-up are limitations in this study.CONCLUSIONSThis is the first study to report the long-term outcomes of TO-TVT in women with urodynamic MUI; TO-TVT is associated with a good and sustained patient-reported success rate in women with MUI up to 9-years follow-up.",

keywords = "mid-urethral slings, stress urinary incontinence, tension-free vaginal tape, transobturator tapes, urinary incontinence",

author = "Mohamed Abdel-Fattah and Gabriel Cao and Alyaa Mostafa",

note = "We thank Dr D. Kramakar (DK) (Research Fellow—University of Aberdeen) for sending out the questionnaires and collating the responses. We thank Lindsey Grant (LG) for performing the independent data entry cross-check. A special gratitude is to all the women whose excellent cooperation made this study successful. The initial phase of this study (up to 3-year follow-up) was funded by the Henry Smith Charity. Dr Karmakar was funded by IUGA Clinical Fellowship Grant 2014.",

year = "2017",

month = apr,

doi = "10.1002/nau.23192",

language = "English",

volume = "36",

pages = "902--908",

journal = "Neurourology and Urodynamics",

issn = "0733-2467",

publisher = "Wiley-Blackwell ",

number = "4",

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TY - JOUR

T1 - Long-term outcomes for transobturator tension-free vaginal tapes in women with urodynamic mixed urinary incontinence

AU - Abdel-Fattah, Mohamed

AU - Cao, Gabriel

AU - Mostafa, Alyaa

N1 - We thank Dr D. Kramakar (DK) (Research Fellow—University of Aberdeen) for sending out the questionnaires and collating the responses. We thank Lindsey Grant (LG) for performing the independent data entry cross-check. A special gratitude is to all the women whose excellent cooperation made this study successful. The initial phase of this study (up to 3-year follow-up) was funded by the Henry Smith Charity. Dr Karmakar was funded by IUGA Clinical Fellowship Grant 2014.

PY - 2017/4

Y1 - 2017/4

N2 - AIMSTo assess the long-term patient reported outcomes following transobturator tension-free vaginal tapes (TO-TVT) in women with urodynamic mixed urinary incontinence (MUI).METHODSA secondary analysis of the 9-year follow-up of the E-TOT study: 341 women with predominant stress urinary incontinence symptoms were randomized to undergo either inside-out or outside-in TO-TVT between April 2005 and April 2007. Forty-eight women had preoperative urodynamic MUI and were available for 9-year follow-up. Primary outcome was the patient-reported success rate defined as very/much improved on Patient's Global Impression of Improvement PGI-I. Secondary outcomes included impact on women's quality of life, sexual function, overactive bladder symptoms,and late adverse events. Statistical analysis was performed using SPSS v.23.RESULTSForty-eight women completed the 9-year follow-up, with adjusted response rate of 63%. The success based on the PGI-I was 64.6% (n = 31), with a further 14.6% (n = 7) who reported “improved.” There was no significant difference between groups (OR 1.11; 95%CI 0.33, 3.70; P > 0.999). Clinically significant improvement in quality of life was found in 85.3%. Cure of urgency and UUI was reported by 35% and 41%, whereas worsening was reported in 6.5% and 2.3%, respectively. One patient reported chronic groin/leg pain. The small sample size and the sizeable loss to follow-up are limitations in this study.CONCLUSIONSThis is the first study to report the long-term outcomes of TO-TVT in women with urodynamic MUI; TO-TVT is associated with a good and sustained patient-reported success rate in women with MUI up to 9-years follow-up.

AB - AIMSTo assess the long-term patient reported outcomes following transobturator tension-free vaginal tapes (TO-TVT) in women with urodynamic mixed urinary incontinence (MUI).METHODSA secondary analysis of the 9-year follow-up of the E-TOT study: 341 women with predominant stress urinary incontinence symptoms were randomized to undergo either inside-out or outside-in TO-TVT between April 2005 and April 2007. Forty-eight women had preoperative urodynamic MUI and were available for 9-year follow-up. Primary outcome was the patient-reported success rate defined as very/much improved on Patient's Global Impression of Improvement PGI-I. Secondary outcomes included impact on women's quality of life, sexual function, overactive bladder symptoms,and late adverse events. Statistical analysis was performed using SPSS v.23.RESULTSForty-eight women completed the 9-year follow-up, with adjusted response rate of 63%. The success based on the PGI-I was 64.6% (n = 31), with a further 14.6% (n = 7) who reported “improved.” There was no significant difference between groups (OR 1.11; 95%CI 0.33, 3.70; P > 0.999). Clinically significant improvement in quality of life was found in 85.3%. Cure of urgency and UUI was reported by 35% and 41%, whereas worsening was reported in 6.5% and 2.3%, respectively. One patient reported chronic groin/leg pain. The small sample size and the sizeable loss to follow-up are limitations in this study.CONCLUSIONSThis is the first study to report the long-term outcomes of TO-TVT in women with urodynamic MUI; TO-TVT is associated with a good and sustained patient-reported success rate in women with MUI up to 9-years follow-up.

KW - mid-urethral slings

KW - stress urinary incontinence

KW - tension-free vaginal tape

KW - transobturator tapes

KW - urinary incontinence

U2 - 10.1002/nau.23192

DO - 10.1002/nau.23192

M3 - Article

SN - 0733-2467

VL - 36

SP - 902

EP - 908

JO - Neurourology and Urodynamics

JF - Neurourology and Urodynamics

IS - 4

ER -

Long-term outcomes for transobturator tension-free vaginal tapes in women with urodynamic mixed urinary incontinence

Abstract

Bibliographical note

Keywords

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