Modified autologous transobturator tape surgery — evaluation of short term results

Objectives: The aim of this study is to evaluate the short-term outcomes of our modified autologous transobturator tape(aTOT) technique with rectus abdominis muscle fascial graft for the treatment of female stress urinary incontinence (SUI).Material and methods: The data of 22 patients who underwent modified aTOT were recorded. Perioperative data regardingoperative time, complications and postoperative visual analogue scores were noted. Patients were assessed 18 monthsafter surgery. The primary endpoints of this study were the improvements in the International Consultation on IncontinenceQuestionnaire-Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) subscores, one-hour pad test and cough stress testrates as an objective cure as well as the improvements in the PGI-I and ICIQ-FLUTS quality of life scores as a subjective cure.Results: Mean age and the mean follow-up period were 51.7 ± 9.8 years and 20.1 ± 0.9 months, respectively. Urethralhypermobility and a positive cough stress test were detected in all the patients. Mean operative time was 43.8 ± 8.1 min.and the overall complication rate was 9%. Mean VAS scores at postoperative 24 hours were 2.6 ± 1.2. At the postoperativeeighteenth month, no patient had a positive cough test and mean PGI-I score was 2 while two patients had moderateurinary incontinence according to the pad test. Pad test results, ICIQ subscores of voiding QoL, incontinence, incontinenceQoL, total score and total QoL score at baseline and eighteen months after surgery were 76.9 ± 19.9, 9.6 ± 4.1, 15.5 ± 4.0,39.5 ± 7.9, 27.9 ± 6.6, 68.4 ± 13.8 and 7.1 ± 2, 10.1 ± 2.4, 6.6 ± 2.1, 13.4 ± 4.5, 20.4 ± 4.8, 39.7 ± 9.2 respectively (p = 0.001,p = 0.004, p = 0.001, p = 0.001, p = 0.001, and p = 0.001, respectively)Conclusions: Modified aTOT is an effective and safe method with low morbidity for SUI treatment in short term