title: Preoperative determinants for failure of transobturator tapes in the management of female urodynamic stress incontinence.
abstract: OBJECTIVE
  To determine significant preoperative risk factors for failure of transobturator tapes.
  
  
  METHODS
  Secondary analysis of data from the E-TOT (Evaluation of Transobturator Tapes) study. Patient-reported outcomes (n=310) and objective outcomes (n=297) were analyzed using univariate and multivariate analyses.
  
  
  RESULTS
  On univariate analysis, body mass index (BMI) >or= 35, maximum urethral closure pressure (MUCP) <or=30 cm H(2)O, preoperative mixed incontinence on urodynamics, history of at least one previous incontinence procedure, and preoperative symptoms of urgency, nocturia, or urgency incontinence were associated with failure. On multivariate regression, BMI >or=35 (OR 6.37; 95% CI, 1.73-23.44; P=0.005), nocturia (OR 2.18; 95% CI, 1.04-4.58; P=0.039), urgency incontinence (OR 3.35; 95% CI, 1.07-10.51; P=0.039), and previous incontinence surgery (OR 2.33; 95%CI, 1.1-5.48; P=0.048) were independently associated with patient-reported failure. MUCP <or=30 cm H(2)O (OR 7.06; 95% CI, 2.85-17.48; P<0.001) and previous incontinence procedure (OR 6.22; 95%CI, 2.34-16.52; P<0.001) were independently associated with objective failure.
  
  
  CONCLUSIONS
  History of previous incontinence surgery was the only independent risk factor for failure of transobturator tapes based on both the patient-reported and objective outcome.
authors.affiliation: Division of Applied Health Sciences, University Of Aberdeen, Aberdeen, UK. m.abdelfattah@abdn.ac.uk
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abdel-Fattah
authors.forename: Akinbowale
authors.initials: A
authors.lastname: Familusi
authors.forename: Ian
authors.initials: I
authors.lastname: Ramsay
authors.forename: Dolapo
authors.initials: D
authors.lastname: Ayansina
authors.forename: Alyaa
authors.initials: A
authors.lastname: Mostafa
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D019919:Prosthesis Implantation / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D012044:Regression Analysis; D012307:Risk Factors; D053825:Suburethral Slings; D017211:Treatment Failure; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics