title: Long-term outcomes for transobturator tension-free vaginal tapes in women with urodynamic mixed urinary incontinence.
abstract: To assess the long-term patient reported outcomes following transobturator tension-free vaginal tapes (TO-TVT) in women with urodynamic mixed urinary incontinence (MUI).
  
  
  
  A secondary analysis of the 9-year follow-up of the E-TOT study: 341 women with predominant stress urinary incontinence symptoms were randomized to undergo either inside-out or outside-in TO-TVT between April 2005 and April 2007. Forty-eight women had preoperative urodynamic MUI and were available for 9-year follow-up. Primary outcome was the patient-reported success rate defined as very/much improved on Patient's Global Impression of Improvement PGI-I. Secondary outcomes included impact on women's quality of life, sexual function, overactive bladder symptoms,and late adverse events. Statistical analysis was performed using SPSS v.23.
  
  
  
  Forty-eight women completed the 9-year follow-up, with adjusted response rate of 63%. The success based on the PGI-I was 64.6% (n = 31), with a further 14.6% (n = 7) who reported "improved." There was no significant difference between groups (OR 1.11; 95%CI 0.33, 3.70; P > 0.999). Clinically significant improvement in quality of life was found in 85.3%. Cure of urgency and UUI was reported by 35% and 41%, whereas worsening was reported in 6.5% and 2.3%, respectively. One patient reported chronic groin/leg pain. The small sample size and the sizeable loss to follow-up are limitations in this study.
  
  
  
  This is the first study to report the long-term outcomes of TO-TVT in women with urodynamic MUI; TO-TVT is associated with a good and sustained patient-reported success rate in women with MUI up to 9-years follow-up.
authors.affiliation: Division of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abdel-Fattah
authors.affiliation: University of Aberdeen, Aberdeen, Scotland.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Cao
authors.affiliation: University of Aberdeen, Aberdeen, Scotland.
authors.forename: Alyaa
authors.initials: A
authors.lastname: Mostafa
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D063868:Patient Outcome Assessment; D019919:Prosthesis Implantation; D053825:Suburethral Slings; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000503:physiopathology* / Q000601:surgery*; D014563:Urodynamics
keywords: mid-urethral slings; stress urinary incontinence; tension-free vaginal tape; transobturator tapes; urinary incontinence