Florencio Manuel Marín-Martínez1, Julián Oñate-Celdrán2, Olimpia Molina-Hernández3, Miriam Artes-Artes4, Emny Rochelle Bobadilla-Romero5, Víctor Javier García-Porcel6, Pablo Luis Guzmán-Martínez Valls7, Angel Andreu-García8, Carlos Sánchez-Rodríguez9, Damián García-Escudero10, Mabel Coromoto Suarez-Pineda11, Pedro Valdelvira-Nadal12. 1. Hospital General Universitario Reina Sofía de Murcia, Murcia (Spain).. flomanuster@gmail.com. 2. Hospital General Universitario Reina Sofía de Murcia, Murcia (Spain).. jonateceldran@gmail.com. 3. Hospital General Universitario Reina Sofía de Murcia, Murcia (Spain).. olimpiamolina89@gmail.com. 4. Hospital General Universitario Reina Sofía de Murcia, Murcia (Spain).. miriam.artes.artes@gmail.com. 5. Hospital General Universitario Reina Sofía de Murcia, Murcia (Spain).. e.r.bobadilla@hotmail.com. 6. Hospital General Universitario Reina Sofía de Murcia, Murcia (Spain).. vic_jgp@hotmail.com. 7. Hospital General Universitario Reina Sofía de Murcia, Murcia (Spain).. pabloguzmanmv@gmail.com. 8. Hospital General Universitario Reina Sofía de Murcia, Murcia (Spain).. thader02@hotmail.com. 9. Hospital General Universitario Reina Sofía de Murcia, Murcia (Spain).. charles_mh@hotmail.com. 10. Hospital General Universitario Reina Sofía de Murcia, Murcia (Spain).. d.garcia.escudero@gmail.com. 11. Hospital Universitario Virgen de la Arrixaca, Murcia (Spain).. mabelsuarezcp13@gmail.com. 12. Hospital General Universitario Reina Sofía de Murcia, Murcia (Spain).. pedro-nadal@hotmail.com.
Abstract
OBJECTIVE: Describe the medium-term safety of the tension free vaginal tape obturator (TVT-O) procedure in terms of complications, cure and changes in quality of life (QoL) after the surgery. MATERIALS AND METHODS: Descriptive historical cohort that included women over 18 years of age who underwent TVT-O due to objectively proven stress urinary incontinence, urethral hypermobility or mixed urinary incontinence in which the stress component predominated, confirmed on urodynamic testing between July 2013-April 2017, in a reference hospital located in the city of Murcia Spain. Women with previous anti-incontinence surgery, concomitant vaginal surgery and planning pregnancy were excluded. Follow-up was determined for each patient based on the time elapsed between surgery and the time when the research protocol was applied. Complications were stratified according to the modified Clavien-Dindo classification; also we evaluated subjective cure rate, quality of life using the ICIQ-SF score, before and after surgery. RESULTS: The mean age was 52.6 (SD± 10.5) years and 80.1% of patients were at least overweight. The incidence of complications at 12 months was: 8.3% (12/144). We did not detect complications after this period in the followed patients at 24, 36 and 48 months. The subjective cure determined at 12, 24, 36 and 48 months was 62.5% (90/144), 59.09% (55/88), 50.81% (31/61) and 50% (7/14), respectively. There was a significant improvement in quality of life, as determined by the ICQ-SF mean score before and after surgery (13.76[6,34] vs 3.84[5.76]; p<0.05). CONCLUSIONS: The TVT-O surgery is a safe therapy associated with a low complication incidence at 12 months, an acceptable subjective cure rate in stress urinary incontinence, and quality-of-life improvement. Classifications of complications related to the insertion of the prosthesis and of those inherent to surgery, such as urinary tract infection, are required.
OBJECTIVE: Describe the medium-term safety of the tension free vaginal tape obturator (TVT-O) procedure in terms of complications, cure and changes in quality of life (QoL) after the surgery. MATERIALS AND METHODS: Descriptive historical cohort that included women over 18 years of age who underwent TVT-O due to objectively proven stress urinary incontinence, urethral hypermobility or mixed urinary incontinence in which the stress component predominated, confirmed on urodynamic testing between July 2013-April 2017, in a reference hospital located in the city of Murcia Spain. Women with previous anti-incontinence surgery, concomitant vaginal surgery and planning pregnancy were excluded. Follow-up was determined for each patient based on the time elapsed between surgery and the time when the research protocol was applied. Complications were stratified according to the modified Clavien-Dindo classification; also we evaluated subjective cure rate, quality of life using the ICIQ-SF score, before and after surgery. RESULTS: The mean age was 52.6 (SD± 10.5) years and 80.1% of patients were at least overweight. The incidence of complications at 12 months was: 8.3% (12/144). We did not detect complications after this period in the followed patients at 24, 36 and 48 months. The subjective cure determined at 12, 24, 36 and 48 months was 62.5% (90/144), 59.09% (55/88), 50.81% (31/61) and 50% (7/14), respectively. There was a significant improvement in quality of life, as determined by the ICQ-SF mean score before and after surgery (13.76[6,34] vs 3.84[5.76]; p<0.05). CONCLUSIONS: The TVT-O surgery is a safe therapy associated with a low complication incidence at 12 months, an acceptable subjective cure rate in stress urinary incontinence, and quality-of-life improvement. Classifications of complications related to the insertion of the prosthesis and of those inherent to surgery, such as urinary tract infection, are required.