Is proximal urethral mobility important for transobturator tape procedure in management of female patients with stress urinary incontinence?

OBJECTIVES

To assess the change in urethral mobility (UM) after the transobturator tape (TOT) procedure and to evaluate the effect of UM on the outcome of the TOT procedure in women with stress urinary incontinence.

METHODS

A total of 159 women 33 to 77 years old (mean 55.3) was included in this study. UM was quantified using the Q-tip angle. Patients were stratified into the urethral hypermobility (UH) group (Q-tip test angle 30 degrees or greater, n = 96) and the non-UH group (Q-tip test angle less than 30 degrees, n = 63). The mean follow-up time was 6.5 +/- 0.4 months.

RESULTS

In the UH group, the Q-tip test values decreased significantly compared with the baseline data (41.2 degrees +/- 1.1 degrees versus 31.0 degrees +/- 1.4 degrees, P <0.001). No difference was evident in the non-UH group (17.0 degrees +/- 0.9 degrees versus 17.0 degrees +/- 1.1 degrees, P = 965). The overall cure rate was not significantly different in either group (91.7% versus 84.1%, P = 0.142). After the TOT procedure, 66 had a Q-tip test result of 30 degrees or greater. The overall cure rate was not significantly different in the postoperative UH and non-UH groups (92.4% versus 86.0%, P = 0.209).

CONCLUSIONS

The results of our study have shown that UM decreases after the TOT procedure in the UH group but not in the non-UH group. The cure rate was not lower in the non-UH group compared with that in the UH group. Our findings suggest that the lack of UM should not be considered a factor indicating a high risk of failure after the TOT procedure.