Korean J Urol.  2014 Aug;55(8):520-526. 10.4111/kju.2014.55.8.520.

Impact of Transobturator Tape Treatment on Overactive Bladder Symptoms, Particularly Nocturia, in Patients With Mixed Urinary Incontinence

• Lee SK
• Kang HW
• Kim WT
• Kim YJ
• Yun SJ
• Lee SC
• Kim WJ

• KMID: 1794586
• DOI: http://doi.org/10.4111/kju.2014.55.8.520

Abstract

PURPOSE
We assessed the impact of transobturator tape (TOT) treatment on overactive bladder (OAB) symptoms with a particular focus on nocturia in patients with mixed urinary incontinence (MUI).
MATERIALS AND METHODS
In this retrospective cohort study, the medical records of 237 women who underwent TOT surgery for the treatment of MUI were reviewed. Of these, 86 patients (36.4%) had preoperative nocturia. Patients with neurological diseases or sleep disorders that could affect the voiding pattern were excluded. Patients who were being treated with anticholinergics and antidiuretic hormones were also excluded, which left 70 subjects eligible for analysis. Pre- and postoperative evaluations consisted of a physical examination, 3-day frequency-volume chart, and health-related quality of life questionnaires (King's health questionnaire, overactive bladder symptom score, and OAB-questionnaire).
RESULTS
TOT treatment resulted in an overall significant improvement in OAB symptoms including nocturia. Frequency-volume charts revealed that TOT treatment significantly decreased the actual number of nightly voids (ANV) and the nocturnal bladder capacity index (NBCi) in the entire cohort. However, in a subgroup of women with nocturnal polyuria, there was no significant change in ANV or NBCi after the sling operation. Correlation analysis of the whole cohort revealed that the postoperative changes in NBCi correlated positively with postoperative changes in ANV. The nocturia-persisting group was more likely to have nocturnal polyuria and lower preoperative functional bladder capacity compared with the nocturia-improved group (p=0.024 and p=0.023, respectively).
CONCLUSIONS
Our results demonstrated that the TOT procedure resulted in an overall significant improvement in OAB symptoms including OAB-related nocturia in patients who presented with MUI.

Keyword

Nocturia; Questionnaires; Transobturator tape; Stress urinary incontinence

MeSH Terms

Adult
Aged
Female
Humans
Middle Aged
Nocturia/physiopathology/*surgery
Retrospective Studies
Severity of Illness Index
*Suburethral Slings
Treatment Outcome
Urinary Bladder/physiopathology
Urinary Bladder, Overactive/physiopathology/*surgery
Urinary Incontinence, Stress/physiopathology/*surgery
Urodynamics/physiology

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