Effect of transobturator tape on overactive bladder symptoms and urge urinary incontinence in women with mixed urinary incontinence.

Abstract

To estimate changes in overactive bladder (OAB) symptoms and urge urinary incontinence (UUI) in patients undergoing the transobturator tape procedure for urinary stress and mixed incontinence. Telephone interviews were conducted using the International Consultation on Incontinence-Female Lower Urinary Tract Symptoms questionnaire, the International Consultation on Incontinence-Overactive Bladder (ICIQ-OAB) questionnaire, and the Verbal Analogue Satisfaction (VeAS) scale. Preoperative OAB scores were compared with postoperative scores in women with stress incontinence only (group 1), mixed incontinence with predominant stress leakage (group 2), and mixed incontinence with predominant urge (group 3). Case notes were reviewed for preoperative assessment and complications. At median follow-up of 13 months, significant improvement was noted in ICIQ-OAB scores, from a median of 10 (1-15) preoperatively to a median of 3 (0-11) postoperatively (P<.001). Overall, UUI was cured in 19 of 44 (43%) patients, improved in a further 16 (36%), and was persistent in only 9 (21%). In group 2 (stress predominant), UUI was cured in 10 of 23 (43.5%) patients, improved in 10 (43.5%), and persistent in three (13%). In group 3 (urge predominant), UUI was cured in 9 of 21 (43%) patients, improved in six (28.5%), and persistent in six (28.5%). Postoperative lower urinary tract symptom scores were low in all three groups (median 4/48 [0-18]). Stress incontinence was cured in 77%, improved in a further 19%, and unchanged in 4%. Median VeAS score was 9 (2-10); 21% (11/52) of participants had low satisfaction scores (less than 8) owing to persistent urge and slow voiding. Marked resolution or improvement (79%) in urge incontinence after the transobturator tape procedure was noted, and no cases of de novo urge incontinence were identified.