Tsia-Shu Lo1,2,3,4, Sukanda Jaili5,6, Yiap Loong Tan7, Pei-Ying Wu8. 1. Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung, Medical Center, 222, Maijin Road, Keelung, Taiwan, Republic of China. 2378@cgmh.org.tw. 2. Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taipei Medical Center, Taipei, Taiwan, Republic of China. 2378@cgmh.org.tw. 3. Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China. 2378@cgmh.org.tw. 4. School of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China. 2378@cgmh.org.tw. 5. Department of Obstetrics and Gynecology, Sarawak General Hospital, Kuching, Sarawak, Malaysia. 6. Fellow of the Division of UroGynecology, Department of Obstetrics & Gynaecology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan. 7. KPJ Healthcare Group, Kuching Specialist Hospital, Kuching, Sarawak, Malaysia. 8. Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung, Medical Center, 222, Maijin Road, Keelung, Taiwan, Republic of China.
Abstract
INTRODUCTION AND HYPOTHESIS: We hypothesized that transobturator tape (TOT) is safe and efficacious for the treatment of urodynamic stress incontinence in the long term. METHODS: We conducted a prospective study of patients with confirmed urodynamic stress incontinence (USI) who underwent a MonarcTM TOT procedure in a tertiary center between February 2006 and March 2009 without other concurrent surgical procedures. Urodynamics were conducted at 1 and 3 years postoperatively. Subjective evaluation included Incontinence Impact Questionnaire (IIQ-7), Urinary Distress Inventory Questionnaire (UDI-6), and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). Objective cure was defined as no urinary leakage demonstrable on provocative filling cystometry and/ or 1-h pad test of <2 g. Subjective cure was based on a negative response to question 3 in UDI-6. Paired-samples t test, chi-square, and Fisher exact tests were applied; p < 0.05 was considered significant. The log-rank tests were used to compare event-free survival. RESULTS: Sixty patients were enrolled, and 56 were evaluated at 5 years postoperatively. The majority were middle aged, postmenopausal, and overweight. Mean operating time was 31.1 ± 8.9 min, intraoperative complications were minor, and median period of follow-up was 80.3 ± 9.6 months. At 5 years of follow-up, objective and subjective cure rates were 89.3 % and 87.5 %, respectively. No mesh-related complications were seen. One patient needed a repeat midurethral sling procedure, and one patient each had bladder and bowel cancer. CONCLUSION: Monarc TOT was safe and retained its high cure rate in the short- and long-term treatment of stress urinary incontinence.
INTRODUCTION AND HYPOTHESIS: We hypothesized that transobturator tape (TOT) is safe and efficacious for the treatment of urodynamic stress incontinence in the long term. METHODS: We conducted a prospective study of patients with confirmed urodynamic stress incontinence (USI) who underwent a MonarcTM TOT procedure in a tertiary center between February 2006 and March 2009 without other concurrent surgical procedures. Urodynamics were conducted at 1 and 3 years postoperatively. Subjective evaluation included Incontinence Impact Questionnaire (IIQ-7), Urinary Distress Inventory Questionnaire (UDI-6), and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). Objective cure was defined as no urinary leakage demonstrable on provocative filling cystometry and/ or 1-h pad test of <2 g. Subjective cure was based on a negative response to question 3 in UDI-6. Paired-samples t test, chi-square, and Fisher exact tests were applied; p < 0.05 was considered significant. The log-rank tests were used to compare event-free survival. RESULTS: Sixty patients were enrolled, and 56 were evaluated at 5 years postoperatively. The majority were middle aged, postmenopausal, and overweight. Mean operating time was 31.1 ± 8.9 min, intraoperative complications were minor, and median period of follow-up was 80.3 ± 9.6 months. At 5 years of follow-up, objective and subjective cure rates were 89.3 % and 87.5 %, respectively. No mesh-related complications were seen. One patient needed a repeat midurethral sling procedure, and one patient each had bladder and bowel cancer. CONCLUSION: Monarc TOT was safe and retained its high cure rate in the short- and long-term treatment of stress urinary incontinence.
Authors: Werner Schäfer; Paul Abrams; Limin Liao; Anders Mattiasson; Francesco Pesce; Anders Spangberg; Arthur M Sterling; Norman R Zinner; Philip van Kerrebroeck Journal: Neurourol Urodyn Date: 2002 Impact factor: 2.696