title: Comparison of TVT and TOT on urethral mobility and surgical outcomes in stress urinary incontinence with hypermobile urethra.
abstract: OBJECTIVE
  To compare the change of urethral mobility after midurethral sling procedures in stress urinary incontinence with hypermobile urethra and assess these findings with surgical outcomes.
  
  
  METHODS
  141 women who agreed to undergo midurethral sling operations due to stress urinary incontinence with hypermobile urethra were enrolled in this non-randomized prospective observational study. Preoperatively, urethral mobility was measured by Q tip test. All women were asked to complete Urogenital Distress Inventory Short Form (UDI-6) and Incontinence Impact Questionnaire Short Form (IIQ-7) to assess the quality of life. Six months postoperatively, Q tip test and quality of life assessment were repeated. The primary surgical outcomes were classified as cure, improvement and failure. Transient urinary obstruction, de novo urgency, voiding dysfunction were secondary surgical outcomes.
  
  
  RESULTS
  Of 141 women, 50 (35. 5%) women underwent TOT, 91 (64.5%) underwent TVT. In both TOT and TVT groups, postoperative Q tip test values, IIQ-7 and UDI-6 scores were statistically reduced when compared with preoperative values. Postoperative Q tip test value in TVT group was significantly smaller than in TOT group [25°(15-45°) and 20° (15-45°), respectively]. When we compared the Q-tip test value, IIQ-7 and UDI-6 scores changes, there were no statistically significant changes between the groups. Postoperative urethral mobility was more frequent in TOT group than in TVT group (40% vs 23.1%, respectively). Postoperative primary and secondary outcomes were similar in both groups.
  
  
  CONCLUSIONS
  Although midurethral slings decrease the urethtal hypermobility, postoperative mobility status of urethra does not effect surgical outcomes of midurethral slings in women with preoperative urethral hypermobility.
authors.affiliation: Ankara Zekai Tahir Burak Woman's Health Education and Research Hospital, Department of Obstetrics and Gynecology, Turkey.
authors.forename: Sabri
authors.initials: S
authors.lastname: Cavkaytar
authors.affiliation: Ankara Zekai Tahir Burak Woman's Health Education and Research Hospital, Department of Obstetrics and Gynecology, Turkey. Electronic address: kuntaykokanali@gmail.com.
authors.forename: Mahmut Kuntay
authors.initials: MK
authors.lastname: Kokanalı
authors.affiliation: Ankara Zekai Tahir Burak Woman's Health Education and Research Hospital, Department of Obstetrics and Gynecology, Turkey.
authors.forename: Ali Irfan
authors.initials: AI
authors.lastname: Guzel
authors.affiliation: Ankara Zekai Tahir Burak Woman's Health Education and Research Hospital, Department of Obstetrics and Gynecology, Turkey.
authors.forename: Irfan
authors.initials: I
authors.lastname: Ozer
authors.affiliation: Ankara Zekai Tahir Burak Woman's Health Education and Research Hospital, Department of Obstetrics and Gynecology, Turkey.
authors.forename: Orhan Seyfi
authors.initials: OS
authors.lastname: Aksakal
authors.affiliation: Ankara Zekai Tahir Burak Woman's Health Education and Research Hospital, Department of Obstetrics and Gynecology, Turkey.
authors.forename: Melike
authors.initials: M
authors.lastname: Doganay
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D053825:Suburethral Slings; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014522:Urethral Diseases / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000150:complications / Q000601:surgery*
keywords: Q tip test; Stress urinary incontinence; TOT; TVT; Urethral hypermobility