Original Article

Long term follow up of the transobturator tape procedure for the treatment of stress urinary incontinence in a tertiary institution in South Africa

  • ANDREAS CHRYSOSTOMOU
  • KARLYN FRANK
  • WILLIAM W. EDRIDGE

Pelviperineology 2014;33(2):45-48

The transobturator tape (TOT) procedure has become the preferred procedure in managing female stress urinary incontinence (SUI) as it is safer than the tension-free vaginal tape (TVT) which was the “gold standard” since 1995. Ours is the first study looking at the continence status eight years after TOT surgery. The objectives of this series were to describe the long-term effectiveness over a maximum period of 8 years and to describe the associated complications. Records of patients of attending the urogynaecology unit at the tertiary Charlotte Maxeke Johannesburg Academic Hospital who underwent the TOT procedure from April 2005 to April 2010 were included. The study population included women who complained of stress urinary incontinence (SUI) and were diagnosed objectively in keeping with the definition by the International Continence Society (ICS). Follow-up was as per the clinic protocol. One-hundred and twenty women had a TOT procedure. The median age of the women in the group was 55.3 years. One case of bladder injury and 2 cases of vaginal perforation occurred intraoperatively. During the follow-up period 1 woman presented with tape erosion, 7 with sling failure, and 2 patients had de-novo detrusor instability. This descriptive study demonstrates a low intra-operative complication rate, a high subjective and objective cure rate and a low risk of complications up to 8 years (median 5 years and 8 months) of follow-up. We therefore recommend this procedure for the management of genuine SUI in women. We believe that the time has arrived for a new “gold standard”.

Keywords: Stress urinary incontinence; Transobturator tape; Tension-free transvaginal tape; Urodynamic studies.