The Comparison of the Treatment Outcomes of Transobturator Tape and Anterior Colporraphy in Stress Urinary Incontinence

Abstract

Introduction: Stress urinary incontinence (SUI) in women had high prevalence and has a negative impact on their quality of life. Surgery is the most effective way to treat this problem. So, this study designed to compare the efficacy of transobturator tape (TOT) versus anterior colporraphy (APR) in stress incontinence patients. Methods: We designed a prospective cohort study. On base of inclusion and exclusion criteria, we had 65 patients (33 patients in TOT group, 32 patients in APR group) were randomly enrolled in this study. Patients data before surgery, 2 months, 6 months and 18 months after surgery were collected and asked them to complete incontinence quality of life questionnaires (IQOL). We used SPSS 18 for data analysis. Results: Mean surgery time in TOT group was significantly less than APR group (P<0.0001). Quality of life at 6 and 18 months after surgery was significantly better in TOT group (P<0.05). Number of incontinence patients at 2, 6 and 18 months after surgery (P<0.01), incontinence during activity at 18 months after surgery (P=0.031), severity of urinary incontinence at 6 months and 18 months after surgery (P<0.001) were significantly lower in TOT group. Complications after surgery was not different between 2 groups (P=0.78). However, 21 cases in TOT group (63.6%) and 9 cases in APR group (28.1%) complained of pain after surgery (P=0.004). The mean of hospitalization was not statistically significant difference (P=0.54). Finally, 23 patients in TOT group (63.9%) and 13 patients in APR group (36.1%) had urinary incontinence within one last month (OR:3.36, 95%, CL: 1,20-9.36, P=0.018). Furthermore, 25 patients in TOT group (61%) and 16 patients in APR group (39%) had more than 90% improvement in their quality of life (OR: 3.12, 95% CL: 1.08-8.97, P=0.031). Conclusion: The results of this study showed that the TOT techniques more efficient than the APR technique. This technique has more success rate, higher satisfaction of patients and can significantly improve patient's quality of life.