Transobturator Tape Operation for the Treatment of Stress Urinary Incontinence in Postmenopausal Women Aged Over 65 Years.
OBJECTIVE
We compared success rates and complication rates in women aged less then and equal to or more than 65 years who had undergone transobturator tape (TOT) surgery for stress urinary incontinence (SUI).


METHODS
This was a retrospective cohort study that included patients who underwent surgery to treat SUI. We separated patients into two groups according to age: younger than 65 years and equal to or older than 65 years. Exclusion criteria were patients with history of incontinence surgery, history of radical pelvic surgery, concomitant pelvic organ prolapse repair, detrusor overactivity, and less than 1 year of postoperative follow-up. The surgical procedures and pre- and postoperative evaluations including urodynamics were performed in a tertiary center. The primary objective was to assess the success rate, patient-reported satisfaction after surgery, and improvement in quality of life (QOL). The secondary outcome the assessment of complications.


RESULTS
A total of 123 women, including 53 (43.1%) women aged less than 65 years, and 70 (56.9%) women aged 65 years and over with SUI who underwent TOT surgery between January 2004, and March 2013. After a median follow-up of 52 (IQR 31) months for the older patients and 54 (IQR 42) months for younger patients, cure rates and patients satisfaction rates were similar in both group (82.9 vs. 81.1%, P = 0.81 and 87.2 vs. 88.6%, P = 0.79, respectively). The improvement in QOL, which was confirmed with changes in Kings Health Questionnaire (KHQ) scores, was similar in both the older and younger women -209.6 (IQR 420.9) vs. -191.1 (IQR 379.4), P = 0.62, respectively). Postoperative complications were similar in both age groups.


CONCLUSIONS
Transobturator tape surgery in the management of SUI is safe and efficient in improving QOL, has high success and patient satisfaction, and low postoperative morbidity rates even in women aged ≥65 years.
Department of Obstetrics and Gynecology, Istanbul University School of Medicine, Istanbul, Turkey.
Cenk
C
Yasa
Department of Obstetrics and Gynecology, Istanbul University School of Medicine, Istanbul, Turkey.
Funda
F
Gungor Ugurlucan
Department of Obstetrics and Gynecology, Istanbul University School of Medicine, Istanbul, Turkey.
Ozlem
O
Dural
Department of Obstetrics and Gynecology, Istanbul University School of Medicine, Istanbul, Turkey.
Harika
H
Yumru
Department of Obstetrics and Gynecology, Istanbul University School of Medicine, Istanbul, Turkey.
Cansu
C
Gunaydin
Department of Obstetrics and Gynecology, Istanbul University School of Medicine, Istanbul, Turkey.
Onay
O
Yalcin
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D000071066:Patient Reported Outcome Measures; D061214:Patient Safety; D017060:Patient Satisfaction; D017698:Postmenopause; D011788:Quality of Life; D012189:Retrospective Studies; D053825:Suburethral Slings; D053832:Surgical Tape; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*
elderly; quality of life; stress urinary incontinence; surgical outcome; trans-obturator tape (TOT)