Korean J Urol.  2010 Aug;51(8):544-549. 10.4111/kju.2010.51.8.544.

Comparison of TOA and TOT for Treating Female Stress Urinary Incontinence: Short-Term Outcomes

• Youn CS
• Shin JH
• Na YG

• KMID: 1997022
• DOI: http://doi.org/10.4111/kju.2010.51.8.544

Abstract

PURPOSE
The transobturator adjustable tape (TOA) sling operation is a new procedure that allows for the adjustment of tension after surgical intervention, thus permitting correction of postoperative incontinence or obstruction. The aim of this study was to compare the efficacy and safety of TOA with that of the transobturator tape (TOT) procedure.
MATERIALS AND METHODS
Between 2008 and 2009, women with stress urinary incontinence (SUI) underwent TOT (n=63) or TOA (n=40). The preoperative evaluation included history taking, physical examination, voiding diary, stress and 1-hour pad tests, and a comprehensive urodynamic examination. Postoperative evaluation was performed at the 1-week and 3-month postoperative follow-up visits.
RESULTS
The overall cure rate was 90.0% for the TOA group and 85.7% for the TOT group. The rate of satisfaction was higher in the TOA group than in the TOT group (95.0% vs. 85.6%). Four patients in the TOA group needed reduced tension as the result of urinary obstruction. The tension of the mesh was tightened in 1 patient because of a certain degree of continuing incontinence. The residual urine volume was significantly lower in the TOA group than in the TOT group (7.8 ml vs. 43 ml, p=0.01).
CONCLUSIONS
TOA allowed postoperative readjustment for a number of days after surgical intervention, which allowed for good short-term treatment outcomes. These data suggest that better subjective and objective results and residual urine volume can be obtained in the TOA group than those achieved with the traditional non-adjustable mesh and without significant postoperative complications.

Keyword

Stress urinary incontinence; Suburethral slings; Treatment outcome

MeSH Terms

Female
Follow-Up Studies
Humans
Physical Examination
Postoperative Complications
Suburethral Slings
Treatment Outcome
Urinary Incontinence
Urodynamics

Figure

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  FIG. 1 (A) Lidocaine injection on Rt. vaginal wall before loosening of the mesh. (B) Rt. vaginal string was pulled down 1 cm for loosening of the mesh due to obstruction. (C) Both superior strings were pulled up 0.5 cm for tightening of the mesh due to stress urinary incontinence (SUI).

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