Objective and subjective cure rates after trans-obturator tape (OBTAPE) treatment of female urinary incontinence.
OBJECTIVE
To evaluate the safety and efficacy of a thermally bonded nonwoven polypropylene mesh in a transobturator suburethral tape procedure (OBTAPE), Mentor-Porges, Le Plessis Robinson, France) for women with stress urinary incontinence.


METHODS
Between January 2003 and January 2005, 129 consecutive women (mean age 57.2 years) underwent OBTAPE) in two academic centers. All the patients had stress urinary incontinence preoperatively. Detrusor instability was ruled out by cystometry. The women were evaluated 1, 6 and 12 months postoperatively. The objective cure rate was evaluated by clinical examination and the subjective cure rate was assessed using the KHQ and BFLUTS questionnaire.


RESULTS
Mean follow-up was 17.2+/-4.7 months (range 4 to 28 months). The objective and subjective cure rates were respectively 89.9% and 77.5%. Most of the patients received general anesthesia (85.3%). Urinary retention was observed in two women (1.5%), necessitating tape adjustment. Voiding difficulties were observed in 7 cases (5.4%) necessitating intermittent self-catheterization for 4.2+/-2.4 days (range 1 to 7 days). Seven patients developed vaginal erosion (one with vaginal extrusion, and two with an obturator abscess). Complete mesh removal was necessary in 6 patients, four of whom had recurrent stress urinary incontinence.


CONCLUSIONS
Our results suggest that the OBTAPE) is an effective treatment for women with stress urinary incontinence. However, vaginal mesh erosion occurred in 6.2% of women, and this implies the need for careful follow-up.
Deval
Bruno
B
Service de Gynécologie, Hôpital Beaujon, Assistance Publique - Hôpitaux de Paris (AP-HP), Université Paris VII, Clichy, France. bruno.deval@bjn.ap-hop-paris.fr
Ferchaux
Jérome
J
Berry
Richard
R
Gambino
Sandro
S
Ciofu
Calin
C
Rafii
Arash
A
Haab
François
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020878:Device Removal; D004869:Equipment Safety; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010147:Pain Measurement; D011126:Polypropylenes / Q000627:therapeutic use; D011788:Quality of Life; D012008:Recurrence; D013526:Surgical Mesh / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome; D014521:Urethra / Q000503:physiopathology / Q000601:surgery; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000628:therapy*; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation
D011126:Polypropylenes