Effects of the transobturator tape procedure on overactive bladder symptoms and quality of life: a prospective study

ABSTRACT Introduction: This study aimed to evaluate the effects of transobturator tape (TOT) on overactive bladder (OAB) symptoms and quality of life. Materials and Methods: Patients with stress-predominant mixed urinary incontinence (MUI) who had undergone TOT procedures were considered candidates for this research. Preoperative assessment included anamnesis, pelvic examination, cough stress test (CST), and validated symptom severity and quality of life (QoL) questionnaires. The primary outcome, improvement and cure rates of OAB symptoms were determined based on the patient's baseline scores in symptom-related questions in OAB-V8. Secondary outcomes included the success rates of SUI, changes in the QoL score and patient satisfaction rates. Results: A total of 104 patients were included in the study. Sixty-two patients underwent TOT placement alone, and 42 patients underwent TOT placement along with prolapse surgery. The mean follow-up period of the patients was 30.47 months range: 13-52 months. At the first-year follow-up, 52 patients (50.0%) and 59 patients (56.7%) reported cure in preoperative urgency and urgency incontinence, respectively. The objective and subjective cure rates were 96.2% and 56.7%, respectively. A total of 80.7% of the cases had a 15-point improvement in QoL scores. Conclusions: MUS is not only a gold standard treatment in SUI but also presents as a promising treatment modality in stress-dominant MUI. Although the improvement rates of OAB symptoms significantly decrease over time, QoL and patient satisfaction rates remain higher than any other treatment in this patient group at the third-year follow-up.摘要 引言：本研究旨在评估经闭孔吊带（transobturator tape, TOT）对膀胱过度活动症（overactive bladder, OAB）症状及生活质量的影响。 材料与方法：本研究纳入接受经闭孔吊带手术的以压力性尿失禁为主的混合性尿失禁（stress-predominant mixed urinary incontinence, MUI）患者作为研究对象。术前评估包括病史采集、盆腔检查、咳嗽压力试验（cough stress test, CST）以及经过验证的症状严重程度与生活质量（quality of life, QoL）问卷。主要结局指标基于OAB-V8量表中症状相关问题的患者基线评分，确定OAB症状的改善率与治愈率。次要结局指标包括压力性尿失禁（stress urinary incontinence, SUI）的治疗成功率、生活质量评分变化以及患者满意度。 结果：本研究共纳入104例患者。其中62例仅接受经闭孔吊带植入术，42例接受经闭孔吊带联合盆腔器官脱垂手术。患者平均随访时长为30.47个月（范围：13~52个月）。在术后1年随访时，分别有52例（50.0%）与59例（56.7%）患者的术前尿急及急迫性尿失禁症状得到治愈。客观治愈率与主观治愈率分别为96.2%与56.7%。总计80.7%的患者生活质量评分提升了15分。 结论：尿道中段悬吊术（midurethral sling, MUS）不仅是压力性尿失禁（stress urinary incontinence, SUI）的金标准治疗方案，同时也是治疗以压力性尿失禁为主的混合性尿失禁的极具前景的术式。尽管随着时间推移，膀胱过度活动症症状的改善率会显著下降，但在术后3年随访时，该患者群体的生活质量与患者满意度仍高于其他任何治疗手段。