title: A prospective study of transobturator tape as treatment for stress urinary incontinence after transvaginal mesh repair.
abstract: OBJECTIVE
  The transobturator suburethral sling is a common surgical treatment for stress urinary incontinence (SUI). In patients with incontinence after trocar-guided transvaginal mesh repair (Prolift), data on outcome remain limited. In the present study, we hypothesized that transobturator tape in such cases is assumed to be as effective as surgery alone.
  
  
  METHODS
  This was a prospective analysis of outcomes of transobturator slings in women who had undergone transvaginal mesh repair and in those who underwent sling surgery alone (controls). Objective cure was defined as the absence of urinary leakage during the stress test at filling cystometry and a negative cough test during pelvic examination. The success rates were evaluated 3-6 months postoperatively.
  
  
  RESULTS
  One hundred women were recruited for the study. Compared to the control group, women after transvaginal mesh repair had a significantly lower objective success rate (62 vs 86%, p = 0.005) and poorer bladder neck mobility (0.5 ± 0.8 vs 1.1 ± 0.5 cm, p = 0.001).
  
  
  CONCLUSIONS
  The transobturator sling has lower objective success rate in women after transvaginal mesh that may be due to decreased bladder neck mobility. Patients with post-mesh repair SUI who opt for sling surgery should be informed of these less satisfactory outcomes during preoperative counseling.
authors: Department of Obstetrics and Gynecology, Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, 92 Sec. 2 Chung-San North Road, Taipei, 104, Taiwan.
authors: Hui-Hsuan
authors: HH
authors: Lau
authors: Tsung-Hsien
authors: TH
authors: Su
authors: Wen-Chu
authors: WC
authors: Huang
authors: Ching-Hung
authors: CH
authors: Hsieh
authors: Chin-Hui
authors: CH
authors: Su
authors: Rhu-Chu
authors: RC
authors: Chang
mesh_terms: D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D011446:Prospective Studies; D053825:Suburethral Slings; D013526:Surgical Mesh; D017211:Treatment Failure; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics / Q000502:physiology