Long-term outcomes of transobturator tension-free vaginal tapes as secondary continence procedures

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Abstract

Purpose
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 languageEnglish
Pages (from-to)1141-1148
Number of pages8
JournalWorld Journal of Urology
Volume35
Issue number7
Early online date18 Nov 2016
DOIs
Publication statusPublished - Jul 2017

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Suburethral Slings
Stress Urinary Incontinence
Groin
Random Allocation
Sample Size
Quality of Life
Pain

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 journalArticle

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abstract = "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.",
keywords = "transobturator tapes, mid-urethral slings, tension-free vaginal tape, urinary incontinence, stress urinary incontinence",
author = "Mohamed Abdel-Fattah and Gabriel Cao and Alyaa Mostafa",
note = "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.",
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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 -