title: Evaluation of transobturator tension-free vaginal tapes in the management of women with mixed urinary incontinence: one-year outcomes.
abstract: OBJECTIVE
  To assess the efficacy of transobturator tapes in the management of women with urodynamic mixed urinary incontinence (UI).
  
  
  METHODS
  A secondary analysis of a prospective randomized study; 83 women with mixed UI on urodynamics and predominant stress UI symptoms were recruited and randomly assigned to undergo "outside-in" or inside-out transobturator tapes. Preoperative assessment included urodynamic assessment and completion of validated symptom severity and quality of life (QoL) questionnaires. The primary outcome was patient-reported success rates at 1-year as assessed by the Patient Global Impression of Improvement (very much/much improved). Secondary outcomes included changes in preoperative urgency/urgency incontinence, changes in QoL scores and comparison between the 2 types of transobturator tapes.
  
  
  RESULTS
  Seventy-seven women completed 1-year follow-up (outside-in [n=42] vs inside-out [n=35]). The patient-reported success rate and objective cure rate were 75% and 90%, respectively. At 1-year follow-up; 40 women (52%) and 31 women (57.4%) reported cure in their preoperative urgency and urgency incontinence, respectively. A total of 74% reported≥10 point improvement in QoL scores.
  
  
  CONCLUSIONS
  In women with urodynamic mixed incontinence and predominant stress UI, transobturator tapes were associated with good patient-reported success rate at 1 year. Urgency/ urgency incontinence are cured in over 50% of women.
authors.affiliation: Division of Applied Health Sciences, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, Scotland, UK.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abdel-fattah
authors.forename: Alyaa
authors.initials: A
authors.lastname: Mostafa
authors.forename: David
authors.initials: D
authors.lastname: Young
authors.forename: Ian
authors.initials: I
authors.lastname: Ramsay
mesh_terms: D000328:Adult; D000368:Aged; D016001:Confidence Intervals; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D011788:Quality of Life; D018570:Risk Assessment; D012720:Severity of Illness Index; D016037:Single-Blind Method; D053825:Suburethral Slings; D013997:Time Factors; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000175:diagnosis* / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000175:diagnosis / Q000601:surgery; D053202:Urinary Incontinence, Urge / Q000175:diagnosis / Q000601:surgery; D014563:Urodynamics