Factors assocıated with increased risk of urge incontinence after trans-obturator tape

Abstract

Purpose

Urge urinary incontinence (UUI) is a common postoperative symptom after the trans-obturator tape (TOT) procedure, often adversely affecting patients’ quality of life (QoL). This study aimed to identify the risk factors that increase the likelihood of UUI, with the goal of addressing these factors to enhance patients’ QoL.

Material and Method

This retrospective analysis included 365 women diagnosed with pure stress incontinence who underwent the TOT procedure from 2015 to 2023. Of these, 112 patients who developed UUI were classified as Group 1, while 253 patients without UUI were designated as Group 2. The study examined factors such as age, body mass index (BMI), number of births, delivery types, menopausal status, follow-up duration, recurrence of stress incontinence, meatal stenosis, post-void residual (PVR), Burch operation rate, and instances of recurrent UTIs. Quality of Life was assessed using the Incontinence QoL (I-QoL) questionnaire. Urge symptoms were evaluated through both a bladder diary (BD) and the Overactive Bladder Symptom Score (OABSS) questionnaire.

Results

Risk factors, including menopause (p = 0.013), increased BMI (p = 0.001), elevated PVR (p = 0.019), meatal stenosis (p = 0.038), and advanced age (p = 0.045), were significantly more prevalent in Group 1 compared to Group 2. Additionally, Group 1 had considerably lower I-QoL scores across all domains, suggesting substantial psychosocial and functional impairment (p < 0.001).

Conclusion

UUI following the TOT procedure is influenced by various modifiable and non-modifiable factors. Through comprehensive pre-operative and postoperative evaluations, high-risk patients can be identified, potentially reducing UUI symptoms and improving their QoL.