Korean J Urol.  2011 Sep;52(9):612-615.

Transobturator Tape Operation Is More Effective in Premenopausal Women than in Postmenopausal Women with Stress Incontinence

Affiliations
  • 1Department of Obstetrics and Gynecology, Baskent University School of Medicine, Ankara, Turkey. pdursun@yahoo.com

Abstract

PURPOSE
Midurethral synthetic slings for female stress urinary incontinence are minimally invasive polypropylene mesh tapes that are inserted under the midurethra with trocars. In the past decade, this new technology has become the most commonly performed procedure for female stress urinary incontinence, replacing the traditional open procedures. However, its effectiveness in pre- and postmenopausal women has not previously been compared.
MATERIALS AND METHODS
We assessed the clinical outcome of the transobturator tape (TOT) procedure in premenopausal (n=45) and postmenopausal (n=49) women by means of self-report and the Urinary Distress Inventory 6 (UDI-6) questionnaire.
RESULTS
The mean age of the pre- and postmenopausal women was 44 and 60 years, respectively. Mean parity was 2.4 and 3, respectively. There were no significant differences with respect to mean operation time, duration of hospitalization, or intraoperative and postoperative complications. However, premenopausal women were more satisfied with the operation than were postmenopausal women (p=0.014). Also, UDI-6 scores were significantly better in premenopausal women (p=0.027).
CONCLUSIONS
The TOT operation appeared to be more effective in premenopausal women with stress urinary incontinence. However, further studies with larger sample sizes are needed to confirm our results.

Keyword

Postmenopause; Premenopause; Suburethral slings; Urinary incontinence, stress

MeSH Terms

Female
Hospitalization
Humans
Parity
Polypropylenes
Postmenopause
Postoperative Complications
Premenopause
Sample Size
Suburethral Slings
Surgical Instruments
Urinary Incontinence
Urinary Incontinence, Stress
Polypropylenes

Reference

1. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Am J Obstet Gynecol. 2002. 187:116–126.
2. Atherton MJ, Stanton SL. The tension-free vaginal tape reviewed: an evidence-based review from inception to current. BJOG. 2005. 112:534–546.
3. Iosif CS, Batra S, Ek A, Astedt B. Estrogen receptors in the human female lower urinary tract. Am J Obstet Gynecol. 1981. 141:817–820.
4. Smith P. Estrogens and the urogenital tract. Studies on steroid hormone receptors and clinical study on a new estradiol-releasing vaginal ring. Acta Obstet Gynecol Scand Suppl. 1993. 157:1–26.
5. Delorme E. Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women. Prog Urol. 2001. 11:1306–1313.
6. Kane AR, Nager CW. Midurethral slings for stress urinary incontinence. Clin Obstet Gynecol. 2008. 51:124–135.
7. de Leval J. Novel surgical technique for the treatment of female stress urinary incontinence: transobturator vaginal tape inside-out. Eur Urol. 2003. 44:724–730.
8. Debodinance P. Trans-obturator urethral sling for the surgical correction of female stress urinary incontinence: outside-in (Monarc) versus inside-out (TVT-O) Are the two ways reassuring? Eur J Obstet Gynecol Reprod Biol. 2007. 133:232–238.
9. Gürel H, Gürel SA. Pelvic relaxation and associated risk factors: the results of logistic regression analysis. Acta Obstet Gynecol Scand. 1999. 78:290–293.
10. Luo X, Shuai HL, Wang XY, Jiang XF, Xie JY. Changes of collagen content in uterine ligaments of perimenopausal women with relaxation of pelvic supports. Zhonghua Fu Chan Ke Za Zhi. 2008. 43:422–424.
11. Waetjen LE, Ye J, Feng WY, Johnson WO, Greendale GA, Sampselle CM, et al. Association between menopausal transition stages and developing urinary incontinence. Obstet Gynecol. 2009. 114:989–998.
12. Sun MJ, Ng SC, Tsui KP, Chang NE, Lin KC, Chen GD. Are there any predictors for failed Burch colposuspension? Taiwan J Obstet Gynecol. 2006. 45:33–38.
13. Akpinar H, Cetinel B, Demirkesen O, Tufek I, Yaycioglu O, Solok V. Long-term results of Burch colposuspension. Int J Urol. 2000. 7:119–125.
14. Langer R, Golan A, Arad D, Pansky M, Bukovsky I, Caspi E. Effects of induced menopause on Burch colposuspension for urinary stress incontinence. J Reprod Med. 1992. 37:956–958.
15. Rechberger T, Futyma K, Jankiewicz K, Adamiak A, Bogusiewicz M, Skorupski P. Body mass index does not influence the outcome of anti-incontinence surgery among women whereas menopausal status and ageing do: a randomised trial. Int Urogynecol J. 2010. 21:801–806.
16. Iosif CS, Batra S, Ek A, Astedt B. Estrogen receptors in the human female lower urinary tract. Am J Obstet Gynecol. 1981. 141:817–820.
17. Robinson D, Cardozo LD. The role of estrogens in female lower urinary tract dysfunction. Urology. 2003. 62:4 Suppl 1. 45–51.
18. Sartori MG, Girão MJ, de Jesus Simões M, Sartori JP, Baracat EC, Rodrigues de Lima G. Quantitative evaluation of collagen and muscle fibers in the lower urinary tract of castrated and under-hormone replacement female rats. Clin Exp Obstet Gynecol. 2001. 28:92–96.
19. Rud T, Andersson KE, Asmussen M, Hunting A, Ulmsten U. Factors maintaining the intraurethral pressure in women. Invest Urol. 1980. 17:343–347.
Full Text Links
  • KJU
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr