Preoperative determinants for failure of transobturator tapes in the management of female urodynamic stress incontinence

Abstract

Objectives: To determine significant preoperative risk factors for failure of transobturator tapes.

Methods: Secondary analysis of data from the E-TOT (Evaluation of Transobturator Tapes) study. Patient-reported outcomes (n=310) and objective outcomes (n=297) were analyzed using univariate and multivariate analyses.

Results: On univariate analysis, body mass index (BMI) >or= 35, maximum urethral closure pressure (MUCP) <or=30 cm H(2)O, preoperative mixed incontinence on urodynamics, history of at least one previous incontinence procedure, and preoperative symptoms of urgency, nocturia, or urgency incontinence were associated with failure. On multivariate regression, BMI >or=35 (OR 6.37; 95% CI, 1.73-23.44; P=0.005), nocturia (OR 2.18; 95% CI, 1.04-4.58; P=0.039), urgency incontinence (OR 3.35; 95% CI, 1.07-10.51; P=0.039), and previous incontinence surgery (OR 2.33; 95%CI, 1.1-5.48; P=0.048) were independently associated with patient-reported failure. MUCP <or=30 cm H(2)O (OR 7.06; 95% CI, 2.85-17.48; P<0.001) and previous incontinence procedure (OR 6.22; 95%CI, 2.34-16.52; P<0.001) were independently associated with objective failure.

Conclusion: History of previous incontinence surgery was the only independent risk factor for failure of transobturator tapes based on both the patient-reported and objective outcome.