Department of Urology, The Catholic University of Korea, Seoul, Korea.
Int Neurourol J. 2010 Oct;14(3):164-9. doi: 10.5213/inj.2010.14.3.164. Epub 2010 Oct 31.
Recently, as the number of transobturator tape (TOT) procedures has increased, recurrence after this procedure has been frequently reported. However, there are no standard guidelines for treatment. We describe our experience with shortening the previously implanted tape in patients with recurrent stress urinary incontinence after the TOT procedure.
We enrolled 10 women who underwent shortening of the previously implanted tape and were followed up for 3 years. Shortening of the previously implanted tape was done by a figure-eight suture with 1-0 Prolene. One year after TOT shortening, we investigated continence status, patient satisfaction by means of a questionnaire, maximal flow rate (Qmax), and postvoid residual urine volume. Three years after TOT shortening, we evaluated continence status and patient satisfaction.
The mean period of TOT shortening was 4.2 months (range, 1-12 months) after the TOT procedure. One year after TOT shortening, 7 patients showed complete dryness, 2 patients showed improvement, and 1 patient reported failure. Eight patients were very satisfied or satisfied with the 1-year result after TOT shortening. The mean preoperative and postoperative Qmax were 23.8 and 26.7ml/s, respectively, and there was no significant difference. Three years after TOT shortening, 6 patients showed complete dryness, 2 patients showed improvement, and 2 patients reported failure. Among them,1 had failed from 1 year after TOT shortening and the other had shown 1 year of complete dryness. Eight patients were very satisfied or satisfied and 2 patients were dissatisfied with the 3-year result after TOT shortening.
Most of the patients who underwent TOT shortening reported satisfaction as well as improvement of incontinence after a 3-year follow up. Therefore, we suggest that TOT shortening may be recommended primarily in patients with recurrent stress urinary incontinence after the TOT sling procedure.
随着经闭孔吊带（TOT）手术数量的增加，该手术后的复发问题也越来越常见。但目前尚无标准的治疗指南。我们介绍了对 TOT 术后压力性尿失禁复发患者缩短先前植入吊带的经验。
我们纳入了 10 名接受过缩短先前植入吊带手术的患者，并对其进行了 3 年的随访。缩短先前植入的吊带采用 1-0 prolene 双“8”字缝线。在 TOT 缩短术后 1 年，我们通过问卷调查了解了患者的控尿状态和满意度、最大尿流率（Qmax）和残余尿量。在 TOT 缩短术后 3 年，我们评估了患者的控尿状态和满意度。
TOT 缩短的平均时间是在 TOT 手术后 4.2 个月（1-12 个月）。TOT 缩短术后 1 年，7 例患者完全干燥，2 例患者改善，1 例患者失败。8 例患者对 TOT 缩短术后 1 年的结果非常满意或满意。术前和术后平均最大尿流率分别为 23.8 和 26.7ml/s，差异无统计学意义。TOT 缩短术后 3 年，6 例患者完全干燥，2 例患者改善，2 例患者失败。其中 1 例患者在 TOT 缩短术后 1 年失败，另 1 例患者在 TOT 缩短术后 1 年完全干燥。8 例患者非常满意或满意，2 例患者对 TOT 缩短术后 3 年的结果不满意。
大多数接受 TOT 缩短术的患者在 3 年随访时报告了满意度和尿失禁改善。因此，我们建议 TOT 缩短术可能是 TOT 吊带术后压力性尿失禁复发患者的首选治疗方法。
