The effects of menopause on the quality of life and longterm outcomes of transobturator tape treatment in women with stres urinary incontinence

Abstract

Purpose: We aimed to investigate the effects of menopause on long-term outcomes of transobturator tape (TOT) surgery. Materials and Methods: Patients who underwent TOT surgery were evaluated under two groups as postmenopausal and premenopausal. The International Consultation on Incontinence short-form questionnaire (ICIQ-SF), Incontinence Impact Questionnaire (IIQ-7) and Urogenital Distress Inventory-Short Form (UDI-6) questionnaires were completed by the patients at the 1 st and 5 th -year follow-up sessions. Patients with a postoperative UDI-6 and IIQ-7 score of <10 were considered as cured, those with lower postoperative scores compared to the preoperative period were regarded as improved, and the cases that had higher postoperative scores than preoperative values were interpreted as TOT failure. The TOT success rates were compared between the results obtained from UDI-6 and IIQ-7. Results: A total of 109 patients were included in the study (53 postmenopausal and 56 premenopausal). We contacted with 90 (48 premenopausal and 42 postmenopausal) women at 1 st year control and 80 (44 premenopausal and 36 postmenopausal) women at 5 th year control. There was a significant improvement in all of three questionnaires between the preoperative and post-operative 1 st year control (ICIQ-SF: 15.5±2.5 vs. 1.8±4.3, p <0.001; IIQ-7: 68.9±9.8 vs. 2.75±15.2, p <0.001; UDI-6: 27.1±11.1 vs. 6.0±14.6, p <0.001) and the preoperative and post-operative 5 th year control (ICIQ-SF: 15.5±2.5 vs. 3.1±5.3, p <0.001; IIQ-7: 68.9±9.8 vs. 9.6±26.7, p <0.001; UDI-6: 27.1±11.1 vs. 5.1±10.0, p <0.001). When we compared the premenopausal and postmenopausal patients in terms of recurrent urinary tract infection (UTI); 5 (12%) patients had recurrent UTI in postmenopausal group but no patients had recurrent UTI in premenopausal group at 1 st year follow-up (p=0.039) and similarly the same 5 (13.9%) patients in follow-up had recurrent UTI in postmenopausal group but no patients had recurrent UTI in premenopausal group at 5 th year follow-up (p=0.045). There were no significant differences between the premenopausal and postmenopausal patients in terms of TOT success rates at 1 st and 5 th year control, evaluated with UDI-6 (1st year: p=0.198 and 5 th year: p=0.687) and IIQ-7 (1 st year: p=0.489 and 5 th year: p=0.608) questionnaires. Conclusions: Transobturator tape surgery is an effective and reliable method according to the long-term outcomes reported in this paper. In the current study, we determined that the TOT success rates were not affected by the presence of menopause.

Incontinence outcomes in women undergoing retropubic mid-urethral sling: a retrospective cohort study comparing Safyre™ and handmade sling

“…Other studies using Safyre™ have found recurrent incontinence ranging from 17.6 -21% in up to 96 months of follow-up (13,21). Subjective success rate in the long-term follow-up was 68,7% in HMS and 79,3% in the Safyre™ group, which was lower than the reported by Kenton et al (79% -85%) or Sahin et al (88%) after 5 years (3,22). In fact, a decline in the mid-and long-term MUS treatment success has been repeatedly reported (23)(24)(25).…”

The Most Common Urological Conditions in Postmenopausal Women

“…Significant improvement was found as early as 1 year follow-up. There were no significant differences between pre-and post-menopausal patients in terms of TOT efficacy at both 1 and 5 years of follow-up, suggesting that transobturator tape surgery is an effective treatment for UI regardless of pre-or post-menopausal status [18].…”

TOT in combination with solifenacin or intravaginal prasterone in postmenopausal women with mixed urinary incontinence: A retrospective analysis in 112 patients

“…It has been shown that the incidence of urogynecological diseases increases with advancing age and thus with menopause. 17 As estrogen receptors are expressed along the pelvic floor trigone and uterosacral ligaments including the urethra, vagina, and bladder, reduced estrogen levels in menopause cause both weakening of these anatomical structures and urogenital atrophy with related urinary symptoms. 18 At the same time, bladder capacity and detrusor voiding pressure are significantly reduced in the elderly population.…”

“…18 At the same time, bladder capacity and detrusor voiding pressure are significantly reduced in the elderly population. 17 aged and older women are at higher risk of UI. The present study showed how TOT-P treatment and TOT-S treatment reduced urgency-related symptoms while also achieving improvement in VVA and sexual function.…”