Abstract
To assess the long-term patient-reported outcomes following TO-TVT as a secondary continence procedure in women with recurrent stress urinary incontinence (R-SUI).
Methods
A secondary analysis of the 9-year follow-up of the E-TOT study was performed: 341 women with predominant SUI symptoms were randomised to undergo either Inside-out or Outside-in TO-TVT between April 2005 and April 2007. Forty-six women had R-SUI following previously failed continence surgery at time of randomisation and are the basis of this analysis as a one single cohort. 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 late adverse events and impact on women’s quality of life and sexual function. Statistical analysis was performed using SPSS version 23.
Results
Sixty-three per cent completed the 9-year follow-up. The success based on the PGI-I was 62.1% with no significant difference between groups (OR 5.33; 95% CI 1.03, 27.76; p = 0.094). Clinically significant improvement in QoL was found in 84.2%. Adverse events included vaginal erosions (n = 3) and groin pain (n = 2). The small sample size is a limitation in this study; nevertheless, this is one of the largest cohorts reported for women with R-SUI and the first to report the long-term outcomes of TO-TVT as a secondary continence procedure.
Conclusions
TO-TVT operations are associated with good patient-reported success rates (62%) in women with previous failed continence surgery with up to 9-years follow-up. There is a non-significant trend towards better outcomes with the inside-out TO-TVT.
| Original language | English |
|---|---|
| Pages (from-to) | 1141-1148 |
| Number of pages | 8 |
| Journal | World Journal of Urology |
| Volume | 35 |
| Issue number | 7 |
| Early online date | 18 Nov 2016 |
| DOIs | |
| Publication status | Published - Jul 2017 |
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Keywords
- transobturator tapes
- mid-urethral slings
- tension-free vaginal tape
- urinary incontinence
- stress urinary incontinence
Cite this
Long-term outcomes of transobturator tension-free vaginal tapes as secondary continence procedures. / Abdel-Fattah, Mohamed; Cao, Gabriel; Mostafa, Alyaa.
In: World Journal of Urology, Vol. 35, No. 7, 07.2017, p. 1141-1148.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Long-term outcomes of transobturator tension-free vaginal tapes as secondary continence procedures
AU - Abdel-Fattah, Mohamed
AU - Cao, Gabriel
AU - Mostafa, Alyaa
N1 - Acknowledgements We thank Dr. Karmakar (Research Fellow— University of Aberdeen) for sending out the questionnaires and collating the responses. We thank Lindsey Grant for performing the independent data entry cross-check. A special gratitude goes to all the participants whose excellent cooperation over the years made this study successful. Funding 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 - 2017/7
Y1 - 2017/7
N2 - PurposeTo assess the long-term patient-reported outcomes following TO-TVT as a secondary continence procedure in women with recurrent stress urinary incontinence (R-SUI).MethodsA secondary analysis of the 9-year follow-up of the E-TOT study was performed: 341 women with predominant SUI symptoms were randomised to undergo either Inside-out or Outside-in TO-TVT between April 2005 and April 2007. Forty-six women had R-SUI following previously failed continence surgery at time of randomisation and are the basis of this analysis as a one single cohort. 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 late adverse events and impact on women’s quality of life and sexual function. Statistical analysis was performed using SPSS version 23.ResultsSixty-three per cent completed the 9-year follow-up. The success based on the PGI-I was 62.1% with no significant difference between groups (OR 5.33; 95% CI 1.03, 27.76; p = 0.094). Clinically significant improvement in QoL was found in 84.2%. Adverse events included vaginal erosions (n = 3) and groin pain (n = 2). The small sample size is a limitation in this study; nevertheless, this is one of the largest cohorts reported for women with R-SUI and the first to report the long-term outcomes of TO-TVT as a secondary continence procedure.ConclusionsTO-TVT operations are associated with good patient-reported success rates (62%) in women with previous failed continence surgery with up to 9-years follow-up. There is a non-significant trend towards better outcomes with the inside-out TO-TVT.
AB - PurposeTo assess the long-term patient-reported outcomes following TO-TVT as a secondary continence procedure in women with recurrent stress urinary incontinence (R-SUI).MethodsA secondary analysis of the 9-year follow-up of the E-TOT study was performed: 341 women with predominant SUI symptoms were randomised to undergo either Inside-out or Outside-in TO-TVT between April 2005 and April 2007. Forty-six women had R-SUI following previously failed continence surgery at time of randomisation and are the basis of this analysis as a one single cohort. 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 late adverse events and impact on women’s quality of life and sexual function. Statistical analysis was performed using SPSS version 23.ResultsSixty-three per cent completed the 9-year follow-up. The success based on the PGI-I was 62.1% with no significant difference between groups (OR 5.33; 95% CI 1.03, 27.76; p = 0.094). Clinically significant improvement in QoL was found in 84.2%. Adverse events included vaginal erosions (n = 3) and groin pain (n = 2). The small sample size is a limitation in this study; nevertheless, this is one of the largest cohorts reported for women with R-SUI and the first to report the long-term outcomes of TO-TVT as a secondary continence procedure.ConclusionsTO-TVT operations are associated with good patient-reported success rates (62%) in women with previous failed continence surgery with up to 9-years follow-up. There is a non-significant trend towards better outcomes with the inside-out TO-TVT.
KW - transobturator tapes
KW - mid-urethral slings
KW - tension-free vaginal tape
KW - urinary incontinence
KW - stress urinary incontinence
U2 - 10.1007/s00345-016-1969-1
DO - 10.1007/s00345-016-1969-1
M3 - Article
VL - 35
SP - 1141
EP - 1148
JO - World Journal of Urology
JF - World Journal of Urology
SN - 0724-4983
IS - 7
ER -