Surgical Treatment of Female Stress Urinary Incontinence with a Transobturator Tape: Short Term Results

Hong, Young Kwon; Lee, Young Tae

Abstract

PURPOSE
The aim of the study was to assess the efficacy and safety of a new minimally invasive surgery with an outside-in transobturator tape (Monarc(R)).
MATERIALS AND METHODS
26 women with stress urinary incontinence associated with urethral hypermobility were operated and 6 months of mean follow-up was available. The mean age was 49.6 years (36~65). All patients were assessed before surgery by clinical and urodynamic examination: 6 patients presented with intrinsic sphincter deficiency (Valsalva leak point pressure <60 cmH2O); 9 patients presented with mixed incontinence, three of them with detrusor instability confirmed by cystometry. All patients underwent cystoscopy at the end of the surgery. All patients underwent post-operative clinical examination, uroflowmetry and the patients complaining of post-operative urine leak underwent pad test. Post-operative bladder outlet obstruction was defined as the presence of the following criteria: maximum flow rate <15 ml/s and/or postvoid residual urine >20% of volume voided. RESULTS: 22/26 patients (84.6%) were cured and 4/26 (15.4%) were improved. Mean operating time was 23 minutes. Only intra-operative complication was a vaginal wall penetration in one patient. Post-operative vaginal erosion lasting more than 2 weeks occurred in two patients. 2 cases of de novo urgency occurred. There was no bladder outlet obstruction after surgery. CONCLUSION: Monarc(R) tansobturator tape is a simple, safe and effective procedure confirmed by 6 months of mean follow-up. Longer follow-up is needed to validate this technique.