PREDICTORS OF SUCCESSFUL OUTCOME OF TRANS OBTURATOR VAGINAL TAPE (TOT) SURGERY AND ITS EFFECT ON FEMALE SEXUAL FUNCTION

Abstract

INTRODUCTION To evaluate  predictors of successful outcome of trans obturator vaginal tape (TOT) surgery and its effect on female sexual function   METHOD:Total  59 patients with Stress Urinary Incontinence underwent TOT repair using both “inside out” and  “outside–in” technique.  All patients were sexually active in the previous 6 months.Patient were compared before surgery and 6 months after surgery using :Patient global impression of improvement , International consultation of incontinence questionnaire ,Urogenital distress inventory ,Female sexual Index Questionnaire , Patient perception of intensity of urgency scale RESULT AND DISCUSSION Out of 59 patient, 35 female were pre menopausal and rest 24 were post-menopausal. Mean age was 46.49 yrs of female undergoing surgery. Patients had SUI for 25.42 months before they decided to undergo surgery . Out of 59 patient , 38 patient cured (ICIQ=0 ), 18 improved (ICIQ <12), 3 had no improvement. Female sexual function improved overall and  in all domains , according to FSFI scoring  . In long term three patient had mesh erosion and underwent mesh release or excision. CONCLUSION Trans obturator tape insertion for stress urinary incontinent patient  has good success rate and factors like young age, less severity of urgency, milder grade of stress incontinence , decrease time gap between starting of symptoms and  treatment , parity , lack of chronic co morbid condition had favorable effect. Patient had improvement in all domains of sexual function in both pre and post menopausal group.