title: Transobturator tape procedure with and without concomitant vaginal surgery.
abstract: OBJECTIVE
  We evaluated results and complications of the transobturator tape procedure for female stress urinary incontinence and assessed the effect of concomitant vaginal surgery on the outcome.
  
  
  METHODS
  We prospectively studied consecutive women who underwent the transobturator tape procedure without (group 1) or with (group 2) concomitant vaginal surgery at our institution from 2003 to 2006. Followup was at least 12 months. Preoperative evaluations included medical history, Urogenital Distress Inventory-6, physical examination, urinalysis and culture, and urodynamics. The procedure was performed as an out-in technique. Therapeutic success was defined as complete continence not requiring pad protection. All other outcomes were classified as failures.
  
  
  RESULTS
  A total of 96 patients with a mean age of 63 years (range 37 to 89) who fulfilled study entry criteria comprised the study cohort. Group 1 included 35 patients and group 2 included 61 with 1 or more concomitant vaginal surgeries, including hysterectomy in 28, anterior colporrhaphy in 61, posterior colporrhaphy in 11, and excision of a vaginal granuloma with suture thread and excision of the eroded part of the tape in 1 each. There were no intraoperative complications. One patient per group had transient leg pain. Seven group 2 patients had voiding dysfunction, of whom 3 underwent tape release for a presumed obstructed urethra. Postoperatively 29 women (82.86%) in group 1 and 52 (85.2%) in group 2 were continent throughout the 36.1-month followup (range 12 to 54).
  
  
  CONCLUSIONS
  Transobturator tape is safe and effective for stress urinary incontinence. Voiding dysfunction is more prevalent after concomitant vaginal surgery but that surgery does not affect the transobturator tape continence outcome.
authors.affiliation: Department of Urologic Surgery, Wolfson Medical Center, Holon and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. atsivian@hotmail.com
authors.forename: Alexander
authors.initials: A
authors.lastname: Tsivian
authors.forename: Shalva
authors.initials: S
authors.lastname: Benjamin
authors.forename: Matvey
authors.initials: M
authors.lastname: Tsivian
authors.forename: Meir
authors.initials: M
authors.lastname: Rikover
authors.forename: Baruch
authors.initials: B
authors.lastname: Mogutin
authors.forename: Doron
authors.initials: D
authors.lastname: Korczak
authors.forename: A Ami
authors.initials: AA
authors.lastname: Sidi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008875:Middle Aged; D053825:Suburethral Slings; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014563:Urodynamics; D013520:Urologic Surgical Procedures; D014621:Vagina / Q000601:surgery*