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KMID : 0358320080490070609
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Korean Journal of Urology
2008 Volume.49 No. 7 p.609 ~ p.615
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Changes in Voiding Patterns after Transobturator Tape Operation in Female Patients with Stress Urinary Incontinence
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Kwon Whi-An
Woo Seung-Hyo
Kim Yong-June
Lee Sang-Cheol
Kim Wun-Jae
Yun Seok-Joong
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Abstract
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Purpose:A lot of patients with stress urinary incontinence(SUI) have lower urinary tract symptoms. So we evaluated the changes of voiding pattern following transobturator tape(TOT) operation, and investigated the factors for predicting persistent urinary frequency after operation.
Material and Methods :The items of preoperative evaluations consisted of history taking, physical examination, cystometrography, 3 day frequency-volume chart and symptoms questionnaire. Patients with anticholinergics or any neurologic diseases that affect the voiding pattern were excluded. Between January to November 2006, 46 patients with TOT operation were enrolled, and were reevaluated with physical examination, 3 day frequency-volume chart and symptom questionnaires, postoperatively.
Results:The patients who voided 8 or more times per day had shorter symptom duration and higher body mass index(BMI) than those who voided under 8 times per day(each p＜0.05). In 30 patients who void 8 or moretimes per day preoperatively, 17(56.7%) patients became void under 8 times, postoperatively. In each patient who had urgency or urge incontinence symptoms preoperatively, respective 72.7 and 82.8% resolved their symptoms, postoperatively. No one complained de novo urgency or urge incontinence, postoperatively. In a multivariate analysis, the patient with a history of previous pelvic surgery or moderate to severe urge incontinence was tightly associated with an increased likelihood of persistent urinary frequency after TOT operation (odd ratio[OR] 24.8, 95% confidence interval[CI] 2.044-301.284, p=0.012 and OR 31.9, 95% CI 1.662- 613.619, p=0.022, respectively).
Conclusion:The TOT operation can improve the symptoms of urinary frequency, urgency and urge incontinence in patients with SUI. However, the patients who had previous pelvic surgeriesor moderate to severe urge incontinence should be fully advised for the risk of sustaining frequency, postoperatively.
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KEYWORD
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Urinary stress incontinence, Transobturator tape, Frequency, Urgency, Urge incontinence
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