A Comparison of the Clinical Efficacy of the Transobturator Adjustable Tape (TOA) and Transobturator Tape (TOT) for Treating Female Stress Urinary Incontinence

Abstract

SUMMARY T he current randomized controlled trial was conducted at Ain Shams University Maternity Hospital during the period between October 2015 and August 2016. Only women with a diagnosis of primary urodynamic stress incontinence, who were adversely impacted from social and hygienic aspects, were recruited in the trial. A total number of 49 eligible women diagnosed to have primary urodynamic stress incontinence were recruited in the study, which excluded (n=7) (Did not meet inclusion criteria (n=5) Refused to participate (n=1) Other reasons (n=1)) and were randomized (n=42) into one of two groups: group I (n=21) including women who were planned to undergo standard TOT procedure as the anti-incontinence procedure; and group II (n=21) including women who were planned to undergo TOA procedure. During follow up, 2 patients dropped out; 1 out of group I and 1 out of group II. A final number of 40 women (20 in group I and 20 in group II) continued their follow up and were included in the statistical analysis of this study. The tapes used were not the commercially-available ready-made tapes. They were self-tailored from a 15x15-cm or 30x30-cm macroporous mono-filamentous type I polypropylene mesh designed for hernioplasty operations. In the current trial, the initial preoperative diagnosis of urodynamic stress incontinence was based on presence of a significant patients' symptom, a positive cough stress test and the urodynamic criteria for the 'genuine' type of stress urinary incontinence. Postoperative cure/failure results of the allocated anti-incontinence procedure were judged through objective (cough stress test) and patient reported outcomes. The current study showed significant differences between both groups regarding Satisfaction at one month. Among the patients of group (TOT), 60.0% were satisfied .while among the patients of group (TOA) 90.0% were satisfied 1 month after surgery. The current trial showed significantly less postoperative pain in women who underwent TOA when compared to those who underwent the standard TOT procedure.