Risk factors affecting cure after mid-urethral tape procedure for female urodynamic stress incontinence: comparison of retropubic and transobturator routes.
OBJECTIVE
To identify the risk factors affecting cure after the tension-free vaginal tape procedure (TVT) or transobturator tape procedure (TOT).


METHODS
A total of 121 women with urodynamically proved stress incontinence underwent TVT (n = 61) or TOT (n = 60). We analyzed all data with univariate and multivariate logistic regression analyses.


RESULTS
Univariate analysis revealed that a larger postvoid residual urine volume, greater pad weight test, and lower maximal flow rate were associated with a greater risk of failure to be cured after TVT. A lower maximal urethral closure pressure (MUCP) was associated with a greater risk of failure after the TOT procedure. With additional analysis, we found that a MUCP of <or=40 cm H(2)O (odds ratio [OR] 9.21, P = .004) was associated with a significantly greater risk of failure to be cured after the TOT procedure but not a MUCP of <o=50 cm H(2)O (OR 2.24, P = .21). Multivariate analysis revealed that preoperative detrusor overactivity was an independent risk factor affecting cure after TVT (OR 113.1, 95% confidence interval 1.84-6592.77, P = .02) or TOT (OR 23.7, 95% confidence interval 1.63-344.53, P = .02), and MUCP <o=40 cm H(2)O (OR 8.34, 95% confidence interval 1.52-45.65, P = .01) was another risk factor for TOT.


CONCLUSIONS
The risk factors affecting cure after mid-urethral tape procedures were preoperative detrusor overactivity for TVT and TOT and MUCP <o=40 cm H(2)O for TOT.
Hsiao
Sheng-Mou
SM
Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Pan-Chiao, Taipei, Taiwan.
Chang
Ting-Chen
TC
Lin
Ho-Hsiung
HH
D000368:Aged; D000704:Analysis of Variance; D015331:Cohort Studies; D016001:Confidence Intervals; D003558:Cystoscopy / Q000379:methods; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011183:Postoperative Complications / Q000503:physiopathology; D011379:Prognosis; D011788:Quality of Life; D020127:Recovery of Function; D012008:Recurrence; D012307:Risk Factors; D012720:Severity of Illness Index; D053825:Suburethral Slings; D014521:Urethra / Q000601:surgery; D053201:Urinary Bladder, Overactive / Q000601:surgery; D014550:Urinary Incontinence, Stress / Q000175:diagnosis / Q000601:surgery*; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000379:methods*