[Urodynamic changes after transobturator suburethral tape].
BACKGROUND
Prospective study of urodynamic changes induced by transobturator insertion of suburethral tape a dip-stick under-urethral.


METHODS
25 women with pure (12) or mixed (13) stress urinary incontinence were operated by this technique, allowing urodynamic assessment and completion of the MHU urinary disability questionnaire. Three operators performed these 25 tape insertions in 2 centres (Amiens and St Quentin hospitals) according to a standardized technique. Six months after the operation, patients were reviewed by clinical examination, MHU questionnaire and urodynamic assessment.


RESULTS
The cure rate at 6 months was 80% (20 patients) and the improvement rate was 20% (5 patients). The maximum flow rate decreased from 23.6 ml/s to 18.9 ml/s (p = 0.02) and the post-voiding residual volume increased from 26.8 ml to 66.8 ml (p = 0.01). Urethral resistance increased from 0.16 to. 0.25 (p = 0.03) and maximum closure pressure increased from 43.8 to 47.5 cm H2O (p = 0.02). These results demonstrate the obstructive nature of this suburethral tape. The results of the MHU questionnaire showed accentuation of dysuria (p = 0.04) and improvement of stress urinary incontinence (p < 0.001).


CONCLUSIONS
This prospective study confirms the efficacy of this technique, but analysis of the urodynamic studies and the MHU questionnaire demonstrates obstruction. Long-term surveillance of these patients by uroflowmetry and residual urine appears to be useful to detect possible progression to chronic urinary retention.
Bracq
Arnaud
A
Service d'Urologie et Transplantation, CHU d'Amiens, France. bracqarnaud@hotmail.com
Fourmarier
Marc
M
Boutemy
Frédéric
F
Bats
Michèle
M
Turblin
Jean-Marc
JM
Saint
Fabien
F
Petit
Jacques
J
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D019736:Prostheses and Implants; D014521:Urethra; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000379:methods