medwireNews: The use of transobturator tape offers significant relief from symptoms of overactive bladder (OAB) in patients with mixed urinary incontinence (MUI), study findings indicate.
The benefits of surgery included an improvement in nocturia, which may be explained by a treatment-related increase in nocturnal bladder capacity, the study authors suggest.
Seok Joong Yun (Chungbuk National University, Cheongju, Korea) and colleagues undertook a retrospective cohort study to examine the impact of transobturator tape surgery for the treatment of MUI. They included data on 70 women treated between 2007 and 2012, of whom around one-third had preoperative nocturia.
The women’s mean age was 54.8 years and the proportion with grade 1 and grade 2 stress urinary incontinence was 37.1% and 62.9%, respectively. Following transobturator tape treatment, subjective and objective cure rates were 88.6% and 82.9%, respectively, and the procedure did not cause any serious or irreversible complications.
After surgery, significant improvements were seen in all four domains of the Overactive Bladder Symptom Score: daytime frequency, nocturia, urgency and urgency incontinence all improved, by 0.59, 1.14, 1.21 and 1.25 points, respectively.
Subjective nocturia symptoms also improved, as indicated by a significant reduction in the King’s Health Questionnaire sleep/energy domain score, from 51.04 to 18.40, and by a significant increase in the OAB-questionnaire health-related quality of life sleep subscale score, from 47.71 to 85.57.
Objective data supported these findings, with a significant overall reduction in the actual number of nightly voids and nocturnal bladder capacity index following surgery. Interestingly, these improvements were seen in patients with reduced nocturnal bladder capacity and mixed-type nocturia but not in those with nocturnal polyuria.
Further analysis indicated that the treatment-related change in nocturnal bladder capacity index positively correlated with the attendant change in number of nightly voids.
Finally, patients whose nocturia improved following surgery tended to have better preoperative functional bladder capacity and were less likely to have suffered nocturnal polyuria at baseline than those whose nocturia persisted. No other baseline demographic, clinical or urodynamic variables predicted outcomes.
Writing in the Korean Journal of Urology, Yun and co-authors conclude: “Our study showed that [transobturator tape] treatment results in a significant improvement in the number of nocturia episodes in patients who present with MUI.”
They add: “Improvement in nocturnal bladder capacity after [transobturator tape] treatment may be attributed to a reduction in episodes of nocturia.”
medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2014
By Joanna Lyford, Senior medwireNews Reporter