title: Trans-obturator tape for incontinence: a 3-year follow-up.
abstract: OBJECTIVE
  To assess operative and functional outcomes, including morbidity, after using the trans-obturator tape for stress incontinence.
  
  
  METHODS
  The first 24 consecutive patients undergoing trans-obturator tape insertion in a single centre were included in this retrospective study. All patients were female with a mean age of 63 (range 40-83) years. Fifteen patients (62.5%) suffered from pure stress incontinence, and 9 patients (37.5%) had mixed incontinence. Of the latter, 2 patients also had nocturnal enuresis. Each patient was followed up for between 3 and 12 months postoperatively and again at 36 months. The patients were assessed by clinical examination, ultrasound for residual urinary volume, and subjective satisfaction which was assessed at 3 and 12 months. At 36 months, all patients completed a validated incontinence questionnaire (International Consultation on Incontinence Questionnaire: ICIQ) which assessed female lower urinary tract symptoms and their impact on the quality of life.
  
  
  RESULTS
  All operations were performed under epidural anaesthesia in day surgery, and the mean operative time was 20 (range 15-38) min. Nineteen patients (79.2%) showed significant improvement postoperatively, with 16 of those (66.6%) being completely cured of their incontinence. The remaining 5 patients (20.8%) were considered to have had failed procedures. There were no vascular, bladder, or urethral injuries. One patient had perforation of the vaginal fornix, and 3 patients developed vaginal erosion.
  
  
  CONCLUSIONS
  The trans-obturator tape is a safe and effective treatment for stress incontinence and has a low morbidity after a 3-year follow-up period; however, it should only be performed by clinicians with the relevant surgical expertise and experience in treating female incontinence.
authors.affiliation: Urology Department, Worthing Hospital, Worthing, UK.
authors.forename: W
authors.initials: W
authors.lastname: Al-Singary
authors.forename: I S
authors.initials: IS
authors.lastname: Shergill
authors.forename: S E
authors.initials: SE
authors.lastname: Allen
authors.forename: J A
authors.initials: JA
authors.lastname: John
authors.forename: M
authors.initials: M
authors.lastname: Arya
authors.forename: H R H
authors.initials: HR
authors.lastname: Patel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D053825:Suburethral Slings; D013997:Time Factors; D014550:Urinary Incontinence, Stress / Q000601:surgery*