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15-08-2011 | Gynaecology | Article

Transoburator tapes effective for female urinary incontinence


Free abstract

MedWire News: Up to 90% of women with mixed urinary incontinence (MUI) in which stress urinary incontinence (SUI) symptoms predominate may experience symptom resolution following transoburator tape treatment, UK study results show.

The findings also suggest that women who receive this treatment enjoy significant improvements in their overall quality of life (QoL), say the authors in the American Journal of Obstetrics & Gynecology.

They highlight that the effect on QoL is of particular importance as "women with MUI report a significantly higher negative impact on their lifestyles than women with SUI only."

Mohamed Abdel-Fattah (University of Aberdeen) and team assessed the 1-year outcomes of 77 women with a mean age of 55 years and a pre-existing diagnosis of MUI with predominant SUI symptoms.

All participants underwent transoburator tension-free vaginal taping, using an outside-in (n=42) or inside-out (n=35) method of tape insertion.

Post-intervention outcomes were assessed objectively using urodynamic studies, and subjectively via symptom severity and QoL-related questionnaires, including the King's Health Questionnaire and the Birmingham Bowel Urinary Symptom Questionnaire.

Treatment success (subjective) was defined as self-reporting of symptoms as "very much improved" or "much improved", while cure (objective) was defined as a urinary pad incontinence gain of no more than 1 g of urine during a 1-hour period - in keeping with the International Continence Society's (ICS) definition of incontinence.

Abdel-Fattah and colleagues observed respective success and cure rates of 75.0% and 90.0%. Of note, patient-reported success rates were slightly higher with the outside-in than with the inside-out route, at respective rates of 75.6% and 73.5%.

Urgency symptoms were reported as resolved by 52.0% of the group by the end of the study period, and approximately 50.0% of the group had an improvement of 10 or more points in QoL scores.

Measures of QoL assessed included symptom-related physical and social limitations, sleep, energy, general health, and personal relations.

In all, 47 participants completed a Pelvic Organ Prolapse/Incontinence Sexual Function Questionnaire pre- and post-operatively to indicate their level of sexual functioning.

The authors report that 81.0% of these women showed an improvement in sexual function scores after undergoing transoburator taping compared with before the procedure, irrespective of the taping method used.

"The results of this study provide level II evidence for the efficacy of transoburator tapes in women with MUI, and predominant SUI," conclude Abdel-Fattah et al.

By Lauretta Ihonor

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