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Strathprints serves world leading Open Access research by the University of Strathclyde, including research by the Strathclyde Institute of Pharmacy and Biomedical Sciences (SIPBS), where research centres such as the Industrial Biotechnology Innovation Centre (IBioIC), the Cancer Research UK Formulation Unit, SeaBioTech and the Centre for Biophotonics are based.

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Evaluation of transobturator tension-free vaginal tapes in management of women with recurrent stress urinary incontinence

Abdel-Fattah, Mohamed and Ramsay, Ian and Pringle, Stewart and Hardwick, Chris and Ali, Hassan and Young, David and Mostafa, Alyaa (2011) Evaluation of transobturator tension-free vaginal tapes in management of women with recurrent stress urinary incontinence. Urology, 77 (5). pp. 1070-1075. ISSN 0090-4295

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Abstract

OBJECTIVES To assess the efficacy of transobturator tapes in the treatment of women with recurrent urodynamic stress incontinence. METHODS We performed a secondary analysis of a prospective, randomized, single-blinded study. A total of 341 women were recruited (April 2005 and April 2007) and randomly assigned to undergo "inside-out" TVT-O or "outside-in" TOT-ARIS. Of these women, 46 had undergone >= 1 previous continence procedures and were included in the present study. The preoperative assessment included a urodynamic assessment and completion of validated symptom severity and quality-of-life questionnaires. The primary outcome was the patient-reported success rate at 1 year as assessed using the Patient Global Impression of Improvement (very much/much improved). The secondary outcomes included changes in quality of life, sexual function, the objective success rates defined as negative findings on the standard 1-hour pad test, and a comparison between both routes of transobturator tapes. Multivariate analysis was performed to identify the risk factors for failure. RESULTS All 46 women completed the 1-year follow-up period. The patient-reported success rate and objective cure rate was 69.6% and 76.5%, respectively, with no significant differences between the 2 transobturator routes (P = .104, odds ratio [OR] 2.933, 95% confidence interval [CI] 0.803-10.719; and P = .077, OR 4.524, 95% CI 0.849-24.109, respectively). Of the 46 women, 35 (76.1%) reported >10-point improvement on the total King's Health Questionnaire scores and 71% of sexually active women (n = 22) showed an improvement in the total 12-item Pelvic Organ Prolapse/Incontinence Sexual Function Questionnaire scores. On multivariate analysis, a maximal urethral closure pressure of <30 cm H2O was the only independent risk factor for failure (P = .016, OR 9.206, 95% CI 1.511-56.104). CONCLUSIONS Transobturator tapes have good patient-reported and objective success rates at 1 year of follow-up in women with previous failed incontinence surgery. A low maximal urethral closure pressure was the only independent predictor of failure. UROLOGY 77: 1070-1075, 2011. (C) 2011 Elsevier Inc.