TY - JOUR T1 - Evaluation of transobturator tension-free vaginal tapes in the surgical management of mixed urinary incontinence: 3-year outcomes of a randomized controlled trial. AU - Abdel-Fattah,Mohamed, AU - Hopper,Laura R, AU - Mostafa,Alyaa, Y1 - 2013/07/24/ PY - 2013/07/16/accepted PY - 2013/7/30/entrez PY - 2013/7/31/pubmed PY - 2014/4/22/medline KW - MUI KW - MUS KW - OAB KW - QoL KW - RCT KW - RP-TVT KW - SUI KW - TO-TVT KW - UI KW - mid urethral sling KW - mixed urinary incontinence KW - overactive bladder KW - quality of life KW - randomized controlled trial KW - retropubic tension-free vaginal tape KW - stress urinary incontinence KW - suburethral slings KW - transobturator tension-free vaginal tape KW - urgency incontinence KW - urinary incontinence SP - 114 EP - 9 JF - The Journal of urology JO - J Urol VL - 191 IS - 1 N2 - PURPOSE: We evaluate the clinical effectiveness of transobturator tension-free vaginal tape procedures in the surgical management of mixed urinary incontinence in women at 3-year followup. MATERIALS AND METHODS: In this secondary analysis of a prospective, single-blind, randomized controlled trial 83 of 341 women (24%) with mixed urinary incontinence were randomized to undergo an outside-in (Aris® transobturator sling system 42) or inside-out (TVT™-O 41) transobturator tension-free vaginal tape procedure. Patients were contacted by postal questionnaire at a minimum of 3 years postoperatively. The primary outcome was the patient reported success rate, defined as very much improved/much improved on the PGI-I (Patient Global Impression of Improvement). Secondary outcomes included improvement in quality of life, impact on preoperative urgency/urgency incontinence and repeat surgical treatment for stress urinary incontinence. Outcomes at 3 years were compared between groups (outside-in vs inside-out) and to 1-year outcomes. Analysis was performed using SPSS® version 20 with significance levels set at p = 0.05. RESULTS: A total of 66 women with mixed urinary incontinence completed the 3-year followup (outside-in 35 vs inside-out 31). In each group 2 women underwent further continence surgery. The patient reported success rate was 73.8% with no significant differences between the groups (OR 1.035, 95% CI 0.342-3.134, p = 0.951). Overall 34 (50.1%) and 26 women (56.5%) reported cure of preoperative urgency and urgency incontinence, respectively, and 52 women (86.7%) had a clinically significant improvement in quality of life (18 points or more in total KHQ [King's Health Questionnaire] score) compared to baseline. CONCLUSIONS: Transobturator tape procedures are associated with a good (73.8%) patient reported success rate at a minimum of 3 years of followup in the surgical management of mixed urinary incontinence in women with predominant stress urinary incontinence symptoms. Nearly half of the women reported cure of urgency/urgency incontinence. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/23892190/Evaluation_of_transobturator_tension_free_vaginal_tapes_in_the_surgical_management_of_mixed_urinary_incontinence:_3_year_outcomes_of_a_randomized_controlled_trial_ L2 - https://www.jurology.com/doi/10.1016/j.juro.2013.07.035?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -