Are the outcomes of transobturator tape procedure for female stress urinary incontinence durable in long-term follow-up?

PURPOSE: To evaluate long-term cure rates and late complication rates after treatment for female stress urinary incontinence (SUI) with transobturator tape (TOT) procedure and to compare the outcomes of 1st year versus 5th year.

METHODS: We analyzed 138 women who underwent TOT procedure for pure SUI and mixed urinary incontinence in two institutions during the time period of June 2005-May 2008 retrospectively. We used two kinds of polypropylene monofilament tapes (Heine Medizinurethral support system, Germany and I-STOPCL Medical, France) for the standard outside-in TOT in similar numbers. All patients were evaluated with pelvic examination including cough stress test and International Consultation on Incontinence Questionnaire-Short Form at 3 and 12 months and annually. Our primary outcome measures were rates of objective cure, subjective cure, patient satisfaction and failure for long-term follow-up.

RESULTS: The objective cure, subjective cure and patient satisfaction rates of the 126 women at 1 year were 89.6, 86.5 and 92% respectively. During 5-year follow-up, objective cure rate was stable with 87.3% rate (p = 0.554), whereas subjective cure and patient satisfaction rates were decreased to 65.9 and 73%, respectively (p = 0.001). Complications are reported according to the Clavien-Dindo classification with Gr I 14.3%, Gr II 64.3%, Gr IIIa 7.1% and Gr IIIb 14.3 %.

CONCLUSIONS: TOT procedure is an effective minimal invasive procedure with satisfactory results for female SUI in short term. Although recovery in SUI symptoms was stable during 5-year follow-up, subjective cure and patient satisfaction rates decreased significantly due to urge urinary incontinence symptoms.