Effect of transobturator midurethral sling placement on urgency and urge incontinence: 1-Year outcomes - Abstract

TVT-O placement has been associated with short-term cure/improvement of urgency (U) and urge urinary incontinence (UUI) in a significant proportion of patients.

Further, the observed improvement in U/UUI is associated with improved quality of life (QOL). This study is a prospective continuation aimed to determine if the short-term benefit of TVT-O on U/UUI persists at 12 months postoperatively.

METHODS: Patients with stress-predominant mixed incontinence undergoing TVT-O placement were prospectively assessed using 3-day bladder diary and multiple validated incontinence questionnaires focusing on U (Urgency Perception Score), UUI (International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms), and QOL (Incontinence Impact Questionnaire, Short Form).

RESULTS: Eighty-seven patients achieved 12-month assessment, at which point improvements (versus baseline) in mean daily pad use (2.5-0.9) and mean incontinence episodes (3.6-0.7) were seen (P < 0.05, both comparisons). Seventy-eight percent of patients reported cure of stress incontinence. Questionnaire scores for UUI improved from 2.0(±1.1) to 1.0(±1.1) (P < 0.001), with 32% and 31% of patients reporting cure and improvement, respectively. Similarly, mean Urgency Perception Score improved from 10.1(±4.4) to 6.7(±4.5) (P < 0.001). Eighty-two percent of the patients did not require anticholinergics over the 12-month follow-up period. Furthermore, U outcomes are associated with improvements in QOL.

CONCLUSIONS :TVT-O placement is associated with cure/improvement of U and UUI in a significant proportion of patients with mixed urinary incontinence. Further, the observed improvements in U/UUI persist at 12 months and appear to have a durable positive association with QOL.

Written by:
Habibi JR, Petrossian A, Rapp DE.   Are you the author?
Virginia Commonwealth University School of Medicine; Virginia Urology Center for Incontinence and Pelvic Floor Reconstruction, Richmond, VA.

Reference: Female Pelvic Med Reconstr Surg. 2015 Mar 18. Epub ahead of print.


PubMed Abstract
PMID: 25900059

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