Abstract
Objective
To investigate the role of preoperative maximal urethral closure pressure (MUCP) in
predicting postoperative outcomes of trans-obturator tape (TOT) operation.
Study design
82 patients who underwent TOT surgery due to urodynamically proven stress urinary
incontinence were retrospectively analyzed. Preoperative and 6th month postoperative
results of cough stress tests (CST), Turkish validated Incontinence Impact Questionnaire-7
(IIQ-7) and Urogenital Distress Inventory-6 (UDI-6) quality of life (QOL) questionnaires
were recorded. Patients who had negative CST and more than 50% improvement in the
QOL questionnaires in the postoperative evaluation were classified as cured.
Results
14 (17.1 %) patients had MUCP ≤ 20 cmH2O, 68 (83 %) patients had MUCP > 20 cmH2O.
The postoperative IIQ-7 and UDI-6 QOL scores were significantly improved compared
to preoperative values in both MUCP ≤ 20 cmH2O and MUCP > 20 cmH2O groups. However,
cure rate was lower in the MUCP ≤ 20 cmH2O group than in MUCP > 20 cmH2O group (35.7 %
vs 83.8 %, respectively). Preoperative MUCP measurement and urethral mobility assessment
were found to be independent factors associated with surgical outcome. A preoperative
MUCP ≥ 28.5 cmH2O could predict surgical success after TOT with 92.6 % sensitivity
and 85.7 % specificity.
Conclusions
TOT is a reliable method that has a high efficacy in the surgical treatment of stress
urinary incontinence in short-term. Patients with low MUCP can also benefit from TOT.
However, the success rate of TOT surgery decreases in the presence of low MUCP and
absence of hypermobile urethra.
Keywords
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Biography
Can Tercan is a young surgeon who primarily works in the field of urogynecology and endoscopic surgery. He has invented various surgical instruments and applied for patents.
Biography
Mahmut Kuntay Kokanali is a senior surgeon who primarily works in the field of urogynecology, reproductive endocrinology and endoscopic surgery. He has been involved in more than 50 studies in gynecology literature. He works as an associate professor in a training and research hospital.
Biography
Fatih Aktoz is a young surgeon and investigator who primarily works in the field of minimally invasive gynecology. He has written several studies and book chapters in the field of obstetrics and gynecology.
Biography
Orhan Seyfi Aksakal is a senior surgeon who primarily works in the field of urogynecology. He has invented various patented surgical instruments. He works as a professor in a training and research hospital.
Article info
Publication history
Published online: January 23, 2023
Accepted:
January 22,
2023
Received in revised form:
December 14,
2022
Received:
May 2,
2022
Identification
Copyright
© 2023 Elsevier B.V. All rights reserved.
