Evaluation of per-operative cough stress test during transobturator mid-urethral sling surgery

  • Abdulmuttalip Simsek | simsek76@yahoo.com Bakirkoy Sadi Konuk Research and Training Hospital, Department of Urology, Turkey.
  • Sinan Levent Kirecci Sisli Etfal Research and Training Hospital, Department of Urology, Turkey.
  • Goksel Bayar Sisli Etfal Research and Training Hospital, Department of Urology, Turkey.
  • Kaya Horasanli Sisli Etfal Research and Training Hospital, Department of Urology, Turkey.
  • Faruk Ozgor Haseki Research and Training Hospital, Department of Urology, Turkey.
  • Zafer Gokhan Gurbuz Haseki Research and Training Hospital, Department of Urology, Turkey.

Abstract

Purpose: Currently, it is unclear how the mesh tension should be adjusted on the transobturator tape surgery (TOT) for improving continence. The aim of this study was to evaluate the effects of per-operative cough stress test on TOT. Materials and methods: Between March 2007 and December 2011, 206 women with SUI were enrolled in this study. Patients were randomly categorized to treatment with TOT (96) or TOT with cough stress test (110). The IIQ-7 and the UDI-6 were used to identify satisfaction level. At the end of 1st year, two groups were compared patient characteristics, operation time, duration of hospital stay, cure and complication rates. Results: The cure rate was 84.37% 81/96) versus 83.63% (92/110) in TOT and TOT with cough test groups, respectively. Postoperatively ten patient (10/110, 9.09%) suffered voiding difficulties (> 250 ml residual urine) in TOT with cough stress test group. Five patients were discharged with transurethral catheter, whereas, in traditional TOT group, two patients (2/96, 2.1%) had transient postoperative voiding difficulty and two patients were treated with repeated catheterization for 1 week (p < 0.05). Postoperative groin pain was present in 7/96 (8%) versus 24/110 (22%) in TOT and TOT with cough test groups, respectively (p < 0.05). TOT with cough stress test group had an higher rate of complications like, retention of urine, necessitating to cut the tape, mesh erosion and pain in groin or leg. No patient had resistant voiding difficulty or prolonged urinary retention (> 1 week) in traditional TOT group. Conclusions: We believe that per-operative cough stress test leads to overtreatment of stress urinary incontinence when the complication rates were considered.

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Published
2017-10-03
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Section
Original Papers - Incontinence & Urodynamics
Keywords:
Cough stress test, Transobturator tape, Stress urinary incontinence (SUI)
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How to Cite
Simsek, A., Kirecci, S. L., Bayar, G., Horasanli, K., Ozgor, F., & Gurbuz, Z. G. (2017). Evaluation of per-operative cough stress test during transobturator mid-urethral sling surgery. Archivio Italiano Di Urologia E Andrologia, 89(3), 222-225. https://doi.org/10.4081/aiua.2017.3.222

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