Transobturator Tape Technique for Stress Urinary Incontinence and Long Term Outcomes

Purpose: Even though vairous surgical procedures are developed to treatment of stress urinary incontinance, there has not been yet a gold standard treatment. In this study, we aimed to discuss the application of TOT technique, its complications, safety and the six year follow up results. Material and Methods: 30 patients applied to our clinic and diagnosed SUI were performed TOT. Mean patient age was 49,9 +/- 9,4 (23-64). Demographic parameters, physical and pelvic examination, q tip test, stress test, cystoscopy, ICIQ-SF score, duration of surgery, intraoperative complications, early and late postoperative complications were recorded. Mean follow up was 72,5 +/- 7,1 (44-88) months. Patients were evaluated after 1, 3, 6, 12 and 24 months after surgery. Operations were performed by outside-inside method and by using Safyre(promedon). The outcomes were analysed using Shapiro wilk, paired sample t test, Friedman test and Wilcoxon test. Conclusion: Mean operation time and hospital stay were 21,8(15-35) and 1,3 days(1-2) respectively. Peroperatively, one patient(3,3%) had her vaginal wall pierced by the needle. Bladder, uretral or vascular damage were not seen in any patients. Self catheterization was required for only one (3,3%) patient. At late postoperative period, 1 patient developed de novo urge incontinence (3,3%) and one patient developed (3,3%) left leg pain. 73% of the patients with a median follow up of 72,5 +/- 7,1 (44-88) months were dry. Preopearative ICIQ-SF median value of 12.4 (8-20) were decreased to 1.7 (0-6), and similarly, ped use was decreased from 2,9 (1-8) to 0,4 (0-3). Results: TOT is a safe and effective treatment of SUI with its long term outcomes. However, long term outcomes with comparison with other techniques and including higher cohorts is required.