3| Volume 211, P200, April 2017

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Long-term satisfaction rate of two different trans-obturator techniques for surgical treatment of women with urinary incontinence: a randomized study follow-up

      Introduction and aim of the study: We performed a follow-up of our 2007 randomized study in which we compared short-term results of the inside-out (TVT-O) and the outside-in (Monarc) trans-obturator techniques for treatment of women with SUI/MUI in order to evaluate the long-term results of both methods.
      Materials and methods: Women (N = 120) who participated in primary study were included. History, gynecological examination, POP-Q, ultrasound, Q-tip test, pad test, and uroflowmetry were performed. Urinary culture was obtained in symptomatic patients. SPSS Statistics Programme 21.0 was used for the analysis. Descriptive statistics were calculated on basic patients’ characteristics. We used non-parametric tests for numerical data comparisons between/within groups and Pearson's Chi-square to compare categorical data between groups. Statistical significance was set at p < 0.05.
      Results: 92/114 women (6 passed away) responded (80.7%), 52 underwent Monarc and 40 TVT-O. Average time from the operation was 10.2 ± 0.6 years. There was no difference in basic patients’ characteristics, Q-tip test, pad test, and uroflowmetry results between both groups. Average satisfaction rate (scale 0–100%) in the original study was 90.6 ± 14.8% and 81.3 ± 29.3% at the check-up (p = 0.03). For Monarc, satisfaction rates were 90.1 ± 16.1% and 83.3 ± 27.8% (p = 0.185), and for TVT-O 91.4 ± 13.2% and 78.2 ± 31.2% (p = 0.007), respectively. There was no difference in the follow-up satisfaction rates between groups (p = 0.301). No vaginal tape erosions were found and 88.4% of patients had negative stress pad test. 22.8% of patients had positive urinary cultures and these patients had lower satisfaction rates than others (64.9 ± 36.2% versus 86.2 ± 25.3%, p < 0.001).
      Interpretation of results: According to our results, both procedures seem to be equally successful. Satisfaction rate was ≥80% in 79.3% of patients. Only one patient required another anti-incontinence procedure. Some cases of lower success rate could be the consequence of underlying bladder infection and/or co-existing OAB symptoms.
      Conclusions: There is high 10-year satisfaction rate with both procedures.