Transobturator adjustable tape (TOA) in female stress urinary incontinence associated with low maximal urethral closure pressure.
OBJECTIVE
To determine the success rate of transobturator adjustable tape (TOA, Agency for Medical Innovations, A.M.I., Austria) in stress urinary incontinent patients with maximal urethral closure pressure (MUCP) < or =20 cm H(2)O compared to those with MUCP >20 cm H(2)O.


METHODS
In this retrospective study, all female patients with a diagnosis of stress urinary incontinence underwent TOA, from September 2005 to August 2007. All patients had preoperative multichannel urodynamic tests (cystometry, urethral profile and uroflowmetry). During September 2008, patients were contacted by telephone and the validated short forms of the Urogenital Distress Inventory (UDI-6) questionnaire and the Incontinence Impact Questionnaire (IIQ-7) were administered.


RESULTS
The chart review identified 146 patients (125 with MUCP >20 cm H(2)O and 21 with MUCP < or =20 cm H(2)O) who had undergone TOA and who met the inclusion criteria. Of these, 121 patients (82.9%) were contacted by telephone. Results showed a very good quality of life (score 0-7 in the IIQ-7) in 95.9% of patients. Only two (1.6%) patients had persistent significant urine leakage related to physical activity. In the MUCP < or =20 cm H(2)O group, 90% of patients could be considered as being very satisfied, with a very good quality of life.


CONCLUSIONS
With the TOA procedure, the obturator route could be used to treat patients with urinary incontinence and also with low MUCP.
Gynaecology and Obstetrics Department, University of Genoa, Genoa, Italy.
Sergio
S
Costantini
Chiara
C
Nadalini
Francesca
F
Esposito
Franco
F
Alessandri
Mario Menada
MM
Valenzano
Emanuela
E
Mistrangelo
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D053825:Suburethral Slings / Q000009:adverse effects*; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000601:surgery*; D016055:Urinary Retention / Q000209:etiology* / Q000503:physiopathology; D014563:Urodynamics