Impact of Preoperative Patient Characteristics and Flow Rate on Failure, Early Complications, and Voiding Dysfunction After a Transobturator Tape Procedure: A Multicentre Study
Purpose To evaluate the impact of preoperative patient characteristics and flow rate on failure, early postoperative complications, and voiding in patients who underwent transvaginal tension-free vaginal tape-obturator (TVT-O) treatment for uncomplicated stress urinary incontinence (SUI). Methods We...
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Korean Continence Society
2017-12-01
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doaj-e1e9350913264495a272bd2868a0948b2020-11-25T00:52:22ZengKorean Continence SocietyInternational Neurourology Journal2093-47772093-69312017-12-0121428228810.5213/inj.1734910.455692Impact of Preoperative Patient Characteristics and Flow Rate on Failure, Early Complications, and Voiding Dysfunction After a Transobturator Tape Procedure: A Multicentre StudyAndrea Cocci0Giovanni E. Cacciamani1Giorgio Ivan Russo2Maria Angela Cerruto3Martina Milanesi4Luis G. Medina5Sebastiano Cimino6Walter Artibani7Giuseppe Morgia8Marco Carini9Vincenzo Li Marzi10 Department of Urology, University of Florence, Florence, Italy Department of Urology, Polo Chirurgico “P. Confortini”, Azienda Ospedaliera Universitaria Integrata, Verona, Italy Department of Urology, University of Catania, Catania, Italy Department of Urology, Polo Chirurgico “P. Confortini”, Azienda Ospedaliera Universitaria Integrata, Verona, Italy Department of Urology, University of Florence, Florence, Italy Urology Institute, University of Southern California, Los Angeles, CA, USA Department of Urology, University of Catania, Catania, Italy Department of Urology, Polo Chirurgico “P. Confortini”, Azienda Ospedaliera Universitaria Integrata, Verona, Italy Department of Urology, University of Catania, Catania, Italy Department of Urology, University of Florence, Florence, Italy Department of Urology, University of Florence, Florence, ItalyPurpose To evaluate the impact of preoperative patient characteristics and flow rate on failure, early postoperative complications, and voiding in patients who underwent transvaginal tension-free vaginal tape-obturator (TVT-O) treatment for uncomplicated stress urinary incontinence (SUI). Methods We retrospectively reviewed patients who underwent TVT-O for SUI at 3 Italian centres. The exclusion criteria were predominant voiding and storage symptoms suggestive of detrusor overactivity, the presence of grade >1 urogenital prolapse, previous pelvic radiotherapy or other clinical contraindications for surgical procedures, neurogenic bladder dysfunction, and collagen diseases. Multivariate logistic regression models were constructed to identify predictors of early voiding dysfunction after TVT-O. Results A total of 219 patients underwent TVT-O between January 2010 and December 2015. All patients received follow-up at 3, 6, and 12 months, and underwent a stress test, uroflowmetry, and bladder ultrasound to evaluate the postvoid residual volume. They also responded to the Urogenital Distress Inventory (UDI-6) questionnaire. The rates of persistent incontinence after TVT-O, postoperative complications, and satisfaction were 16.4% (36 of 219), 24.2% (53 of 219), and 86.3% (189 of 219), respectively. Nineteen patients (9.5%) experienced early voiding dysfunction. Based on an analysis of baseline characteristics, we determined that a cutoff value of 9.0 on the UDI-6 predicted postoperative SUI with 62% specificity, 72% sensitivity, and 66% accuracy. In the multivariate logistic regression analysis, a preoperative UDI-6≥9.0 was an independent predictor of postoperative SUI. The predictors of complications were menopause (P = 0.04) and the preoperative UDI-6 score (P = 0.01). Conclusions Menopause and UDI-6 scores could be prognostic factors for persistent SUI after TVT-O. Well-designed prospective studies with a suitable number of patients are needed to corroborate our findings.http://www.einj.org/upload/pdf/inj-1734910-455.pdfUrinary IncontinenceUretrhal SlingUrinary Incontinence, StressTension-Free Vaginal TapeUrodynamics |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Andrea Cocci Giovanni E. Cacciamani Giorgio Ivan Russo Maria Angela Cerruto Martina Milanesi Luis G. Medina Sebastiano Cimino Walter Artibani Giuseppe Morgia Marco Carini Vincenzo Li Marzi |
spellingShingle |
Andrea Cocci Giovanni E. Cacciamani Giorgio Ivan Russo Maria Angela Cerruto Martina Milanesi Luis G. Medina Sebastiano Cimino Walter Artibani Giuseppe Morgia Marco Carini Vincenzo Li Marzi Impact of Preoperative Patient Characteristics and Flow Rate on Failure, Early Complications, and Voiding Dysfunction After a Transobturator Tape Procedure: A Multicentre Study International Neurourology Journal Urinary Incontinence Uretrhal Sling Urinary Incontinence, Stress Tension-Free Vaginal Tape Urodynamics |
author_facet |
Andrea Cocci Giovanni E. Cacciamani Giorgio Ivan Russo Maria Angela Cerruto Martina Milanesi Luis G. Medina Sebastiano Cimino Walter Artibani Giuseppe Morgia Marco Carini Vincenzo Li Marzi |
author_sort |
Andrea Cocci |
title |
Impact of Preoperative Patient Characteristics and Flow Rate on Failure, Early Complications, and Voiding Dysfunction After a Transobturator Tape Procedure: A Multicentre Study |
title_short |
Impact of Preoperative Patient Characteristics and Flow Rate on Failure, Early Complications, and Voiding Dysfunction After a Transobturator Tape Procedure: A Multicentre Study |
title_full |
Impact of Preoperative Patient Characteristics and Flow Rate on Failure, Early Complications, and Voiding Dysfunction After a Transobturator Tape Procedure: A Multicentre Study |
title_fullStr |
Impact of Preoperative Patient Characteristics and Flow Rate on Failure, Early Complications, and Voiding Dysfunction After a Transobturator Tape Procedure: A Multicentre Study |
title_full_unstemmed |
Impact of Preoperative Patient Characteristics and Flow Rate on Failure, Early Complications, and Voiding Dysfunction After a Transobturator Tape Procedure: A Multicentre Study |
title_sort |
impact of preoperative patient characteristics and flow rate on failure, early complications, and voiding dysfunction after a transobturator tape procedure: a multicentre study |
publisher |
Korean Continence Society |
series |
International Neurourology Journal |
issn |
2093-4777 2093-6931 |
publishDate |
2017-12-01 |
description |
Purpose To evaluate the impact of preoperative patient characteristics and flow rate on failure, early postoperative complications, and voiding in patients who underwent transvaginal tension-free vaginal tape-obturator (TVT-O) treatment for uncomplicated stress urinary incontinence (SUI). Methods We retrospectively reviewed patients who underwent TVT-O for SUI at 3 Italian centres. The exclusion criteria were predominant voiding and storage symptoms suggestive of detrusor overactivity, the presence of grade >1 urogenital prolapse, previous pelvic radiotherapy or other clinical contraindications for surgical procedures, neurogenic bladder dysfunction, and collagen diseases. Multivariate logistic regression models were constructed to identify predictors of early voiding dysfunction after TVT-O. Results A total of 219 patients underwent TVT-O between January 2010 and December 2015. All patients received follow-up at 3, 6, and 12 months, and underwent a stress test, uroflowmetry, and bladder ultrasound to evaluate the postvoid residual volume. They also responded to the Urogenital Distress Inventory (UDI-6) questionnaire. The rates of persistent incontinence after TVT-O, postoperative complications, and satisfaction were 16.4% (36 of 219), 24.2% (53 of 219), and 86.3% (189 of 219), respectively. Nineteen patients (9.5%) experienced early voiding dysfunction. Based on an analysis of baseline characteristics, we determined that a cutoff value of 9.0 on the UDI-6 predicted postoperative SUI with 62% specificity, 72% sensitivity, and 66% accuracy. In the multivariate logistic regression analysis, a preoperative UDI-6≥9.0 was an independent predictor of postoperative SUI. The predictors of complications were menopause (P = 0.04) and the preoperative UDI-6 score (P = 0.01). Conclusions Menopause and UDI-6 scores could be prognostic factors for persistent SUI after TVT-O. Well-designed prospective studies with a suitable number of patients are needed to corroborate our findings. |
topic |
Urinary Incontinence Uretrhal Sling Urinary Incontinence, Stress Tension-Free Vaginal Tape Urodynamics |
url |
http://www.einj.org/upload/pdf/inj-1734910-455.pdf |
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