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

Research output: Contribution to journalArticle

9 Citations (Scopus)
3 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 languageEnglish
Pages (from-to)902-908
Number of pages7
JournalNeurourology and Urodynamics
Volume36
Issue number4
Early online date28 Dec 2016
DOIs
Publication statusPublished - Apr 2017

Fingerprint

Suburethral Slings
Urodynamics
Urinary Incontinence
Quality of Life
Overactive Urinary Bladder
Stress Urinary Incontinence
Groin
Sample Size
Leg
Pain

Keywords

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

Cite this

@article{8548fc78a6b541dd8c4c3a5a71260c41,
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 = "4",
doi = "10.1002/nau.23192",
language = "English",
volume = "36",
pages = "902--908",
journal = "Neurourology and Urodynamics",
issn = "0733-2467",
publisher = "Wiley-Blackwell",
number = "4",

}

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

VL - 36

SP - 902

EP - 908

JO - Neurourology and Urodynamics

JF - Neurourology and Urodynamics

SN - 0733-2467

IS - 4

ER -