IMPROVEMENT IN QUALITY OF LIFE FOLLOWING THE TRANS-OBTURATOR TAPE PROCEDURE

R. Urwitz-Lane, B. Özel, S. Minaglia, S. Malik, J.J. Klutke
USC-Keck School of Medicine, Los Angeles, CA

OBJECTIVE:  To assess the effect of the trans-obturator tape procedure (TOT) on quality of life using two validated instruments.
MATERIALS AND METHODS:  We reviewed the medical records of all women who had the TOT at our institution between October 2003 and September 2004.  The Urinary Distress Inventory (UDI-6) and the Incontinence Impact Questionnaire (IIQ-7) were administered to all women at their initial evaluation and at a single postoperative clinic visit.  The questionnaires were administered by telephone to women who did not return for follow-up.  Data were analyzed using the paired Student’s t-test.    
RESULTS:  Sixty-nine women undergoing the TOT procedure in the specified time period completed the questionnaires preoperatively, and 42 of these women also completed them postoperatively.  Median follow-up was 3 months.  Mean age and BMI were 49.6 (10.2) years and 34.6 (7.3) kg/m2, respectively. Seven women had the TOT alone; the remainder had concomitant procedures.  Forty-two women had a preoperative diagnosis of urodynamic stress incontinence; 12 had concomitant detrusor overactivity; and 1 had intrinsic sphincteric deficiency.  Mean UDI-6 scores decreased from 44.8 (17.0) to 17.1 (16.8), with 3 women scoring the same and 3 scoring worse post-operatively.  The mean stress subscale score of the UDI-6 decreased from 68.6 (27.0) to 16.7 (23.6), and the mean urge subscale score decreased from 60.5 (36.7) to 29.1 (27.7).  Mean IIQ scores decreased from 50.4 (28.9) to 15.1 (23.1) with 1 woman scoring the same and 3 women scoring worse post-operatively.  All of these differences were highly statistically significantly different (p<0.0001 for all).
CONCLUSIONS:  The TOT results in a significant improvement in patients’ quality of life and incontinence symptoms as measured by the UDI-6 and IIQ-7 at short term follow-up.

Key Words: TOT, quality of life, urinary incontinence

Disclosure –Consultant: J.J. Klutke, Mentor Corp.