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jsmc-10110


EARLY OUTCOME OF TOT SURGERY FOR URINARY INCONTINENCE IN SULAIMANI TEACHING HOSPITAL


Diar Hameed Bajalan a, b, Mohammed Abed Alkadum Hassan cAli Kamal M. Sami a , Ahmed Abdulwahab d and Ismaeel Hama Ameen a


a Department of Surgery, College of Medicine, University of Sulaimani. 
c MOH, Sulaimani Directorate. 
d MOH, Directorate of Babil. 


Submitted: 4/2/2017; Accepted: 1/8/2017


ABSTRACT

Background

Female urinary incontinence is a major health issue affecting about 30% of adult women and majority of them is stress type. Transobturator tape (TOT) technique is relatively safe and associated with minimum complication rate.

Objectives

To identify the safety, success rate and efficacy of TOT procedures performed for female patients with stress urinary incontinence. 

Patients and Methods

A prospective study included thirty patients with history of urinary incontinence (22 patients with stress type and 8 patients with mixed type UI). They underwent TOT procedure in Sulaimani teaching hospital under general or spinal anesthesia; they were collected over a year from June 2014 to June 2015, all of them referred from urological clinic with history of stress or mixed urinary incontinence. The response of TOT surgery was assessed in both subjective and objective ways, using the ICIQ-UI short form and both cough stress test and Q-tip test (before and after surgery), 20 of them had urodynamic study before surgery to confirm the diagnosis, follow up done at one week, three months and six months postoperatively. 

Results 

A total of 30 females with mean age (48.8±9.51) years, Mean number of deliveries for studied females was (4.9±2) deliveries. Main type of urinary incontinence among studied females was stress urinary incontinence (73, 3%); followed by mixed urinary incontinence (26, 7%), all of them were from Sulaimani city and its peripheries. In this study; we found that the success rate is 80% (considering both objective and subjective outcome) which is comparative to similar studies. The early complications were mainly perineal (groin) and upper thigh pain, while the late complications were the development of de novo detrusor over activity, there were no vaginal or urethral erosions. 

Conclusion

Transobturator tape (TOT) is an efficient and safe way of managing stress urinary incontinence with high success rate and short hospitalization with minimum and simple early complications.

KEYWORDS

Urodynamic, Transobturator tape (TOT), Stress urinary incontinence.