No abstract

Aims: The aim of this study is to report the functional results, patient satisfaction, and morbidity of the Transobturator tape procedure (TOT) in the treatment of stress incontinence (SUI). Methods: One hundred and thirty patients were prospectively evaluated with history, physical examination, quality of life questionnaire including Incontinence Impact Questionnaire (IIQ), urogenital distress inventory (UDI), and analog global satisfaction scale (GSS), and urodynamic studies. Results: One hundred and seventeen patients (90%) had history of SUI, and 78 (60%) had urge incontinence. Pads/day (PPD) used was 2.48 AE 2.42, and the score of IIQ 16.13 AE 7.86, UDI 10.95 AE 3.4, and GSS 1.41 AE 1.67. All patients underwent TOT using the ObTape TM . Hospital stay was 0.84 AE 0.76 days and catheter duration was 1.42 AE 2.08 days. At a follow-up of 16.85 AE 4.68 months, 13 patients (10%) have recurrent SUI, 21 (16.15%) persistent urge incontinence, and 1 (1.92%) de novo urge incontinence. The mean PPD is 0.15 AE 0.56, IIQ 1.47 AE 5.14, UDI 3.28 AE 3.09, and GSS 8.29 AE 1.64. Two patients (1.52%) developed urethral obstruction, ¢ve (3.84%) had vaginal extrusion of the tape, and two (1.52%) had intra-operative bladder perforation.Conclusions: These results demonstrate the safety and e⁄cacy of the TOT. The short hospitalization and catheterization, low incidence of de novo urge incontinence and obstructive voiding o¡ers a distinct advantage over existing techniques. No signi¢cant di¡erence in outcome between patients with VLPP 60 cm H 2 O, and patients with VLPP >60 cm H 2 O was observed. Neurourol.

Stress urinary incontinence in the male patient has been successfully treated with the artificial urinary sphincter. However, approximately 15% of the patients treated are still significantly wet despite some improvement with this device. These patients usually are almost totally incontinent before artificial sphincter implantation. Of 15 such patients 80% were rendered satisfactorily dry by adding a second sphincter cuff around the bulbous urethra. This double cuff technique increases the success rate with the AMS800 sphincter to greater than 95%.