OBJECTIVE: To determine if repeat transobturator tape (TOT) is feasible after failed initial synthetic mid-urethral sling (MUS) for stress urinary incontinence, and to ascertain objective physician-determined outcome as well as subjective questionnaire-based outcome for this procedure. PATIENTS AND METHODS: Between February 2005 and February 2008, a total of 21 patients underwent repeat TOT procedure after failed sling treatment. Initial sling procedures were all synthetic MUS, i.e. tension-free vaginal tape in 5 cases and TOT in 16 cases. RESULTS: At a mean follow-up of 16 months, physician-determined cure was achieved in 55% of patients, improvement in 15% and failure in 30%. Outcome deduced from the International Consultation on Incontinence Questionnaire at a mean follow-up of 17 months showed 53% of patients to be cured and 5% of patients to be improved, but failure was noted in 42% of patients. CONCLUSIONS: Repeat TOT after failed synthetic MUS treatment is a feasible procedure with minor morbidity. Repeat TOT provides a reasonable physician-determined success rate, but a lower patient self-reported success rate can be deduced from questionnaires. The transobturator approach seems to show poorer outcomes than the retropubic approach in repeat sling surgery. Copyright 2009 S. Karger AG, Basel.
OBJECTIVE: To determine if repeat transobturator tape (TOT) is feasible after failed initial synthetic mid-urethral sling (MUS) for stress urinary incontinence, and to ascertain objective physician-determined outcome as well as subjective questionnaire-based outcome for this procedure. PATIENTS AND METHODS: Between February 2005 and February 2008, a total of 21 patients underwent repeat TOT procedure after failed sling treatment. Initial sling procedures were all synthetic MUS, i.e. tension-free vaginal tape in 5 cases and TOT in 16 cases. RESULTS: At a mean follow-up of 16 months, physician-determined cure was achieved in 55% of patients, improvement in 15% and failure in 30%. Outcome deduced from the International Consultation on Incontinence Questionnaire at a mean follow-up of 17 months showed 53% of patients to be cured and 5% of patients to be improved, but failure was noted in 42% of patients. CONCLUSIONS: Repeat TOT after failed synthetic MUS treatment is a feasible procedure with minor morbidity. Repeat TOT provides a reasonable physician-determined success rate, but a lower patient self-reported success rate can be deduced from questionnaires. The transobturator approach seems to show poorer outcomes than the retropubic approach in repeat sling surgery. Copyright 2009 S. Karger AG, Basel.
Authors: Laurent de Landsheere; Jean Philippe Lucot; Jean Michel Foidart; Michel Cosson Journal: Int Urogynecol J Date: 2010-06-15 Impact factor: 2.894
Authors: Jerry G Blaivas; Rajveer S Purohit; Matthew S Benedon; Gabriel Mekel; Michael Stern; Mubashir Billah; Kola Olugbade; Robert Bendavid; Vladimir Iakovlev Journal: Nat Rev Urol Date: 2015-08-18 Impact factor: 14.432