POSTER ABSTRACTS 40
41 ABSTRACT #P-A1 TRANSOBTURATOR TAPE FOR THE TREATMENT OF STRESS URINARY INCONTINENCE: EFFECTIVENESS AND PREDICTORS OF OUTCOME Maria Augusta T. Bortolini[F], Victor Mir<strong>and</strong>a, Raed S. Ahmed, Andrea Lischka, Heng R. Wang, May Alarab, Danny Lovatsis, Harold P. Drutz Urogynaecology Division, <strong>Department</strong> <strong>of</strong> <strong>Obstetrics</strong> & Gynaecology, Mount Sinai Hospital. Objective: The objective <strong>of</strong> the study was to determine the success rate <strong>and</strong> predictors <strong>of</strong> failure <strong>of</strong> transobturator tape (TOT) for the surgical treatment <strong>of</strong> stress urinary incontinence (SUI) in women. Methods: Retrospective data collection was performed for 250 women who had undergone TOT in Mount Sinai Hospital, <strong>Toronto</strong>, between February 2005 <strong>and</strong> August 2008. Preoperative <strong>and</strong> postoperative assessment included history, physical examination, ur<strong>of</strong>lowmetry <strong>and</strong> multichannel urodynamic testing. Postoperative follow-up took place at 6 weeks, 6 months <strong>and</strong> then annually. Multichannel urodynamic testing was repeated at 1 year follow-up. Subjective success was defined as lack <strong>of</strong> stress urinary incontinence symptoms <strong>and</strong> objective success was defined as a negative cough test during physical exam. Statistical analysis was performed using simple descriptive techniques. Multivariable Cox regression analysis was used to evaluate predictors <strong>of</strong> failure. Local ethics board approval was obtained. Results: During the study period, 265 TOT were performed; however, 15 cases were excluded because <strong>of</strong> inaccessible records. This study therefore included 250 cases <strong>of</strong> whom 237 (94.8%) primary cases <strong>of</strong> SUI. The mean age was 56.59, BMI was 27, parity was 2.42, 44.5% had estrogen therapy replacement, 65% had associated overactive bladder symptoms <strong>and</strong> 110 (44%) patients had concomitant surgeries (11% had hysterectomy, 42% had anterior <strong>and</strong>/or posterior repair, <strong>and</strong> 16% had sacrospinous vault suspension or laparoscopic colposacropexy). The mean follow-up time was 8.5 months (range 1.5 – 36 months). Objective success rate was 84.6% <strong>and</strong> subjective success rate was 78% in 6 months, <strong>and</strong> 92.6% <strong>and</strong> 86.6%, respectively, at the end <strong>of</strong> 1 year. Variables as age, BMI > 30, smoking, vaginal delivery, menopause status, HRT <strong>and</strong> previous gynecology surgery were not predictors <strong>of</strong> failure. Menopause, previous hysterectomy <strong>and</strong> BMI > 30 increased the chances <strong>of</strong> failure in 1.7, 3 <strong>and</strong> 2.3 times, respectively, but were not statistically significant. Conclusions: We concluded that TOT procedure is effective with a success rate <strong>of</strong> 90% at one year follow up. Age, BMI > 30, smoking, vaginal delivery, menopause status, HRT <strong>and</strong> previous gynecology surgery were not predictors <strong>of</strong> failure.