Preoperative determinants for failure of transobturator tapes in the management of female urodynamic stress incontinence.

OBJECTIVES

To determine significant preoperative risk factors for failure of transobturator tapes.

METHODS

Secondary analysis of data from the E-TOT (Evaluation of Transobturator Tapes) study. Patient-reported outcomes (n=310) and objective outcomes (n=297) were analyzed using univariate and multivariate analyses.

RESULTS

On univariate analysis, body mass index (BMI) >or= 35, maximum urethral closure pressure (MUCP) <or=30 cm H(2)O, preoperative mixed incontinence on urodynamics, history of at least one previous incontinence procedure, and preoperative symptoms of urgency, nocturia, or urgency incontinence were associated with failure. On multivariate regression, BMI >or=35 (OR 6.37; 95% CI, 1.73-23.44; P=0.005), nocturia (OR 2.18; 95% CI, 1.04-4.58; P=0.039), urgency incontinence (OR 3.35; 95% CI, 1.07-10.51; P=0.039), and previous incontinence surgery (OR 2.33; 95%CI, 1.1-5.48; P=0.048) were independently associated with patient-reported failure. MUCP <or=30 cm H(2)O (OR 7.06; 95% CI, 2.85-17.48; P<0.001) and previous incontinence procedure (OR 6.22; 95%CI, 2.34-16.52; P<0.001) were independently associated with objective failure.

CONCLUSION

History of previous incontinence surgery was the only independent risk factor for failure of transobturator tapes based on both the patient-reported and objective outcome.