Transobturator vaginal tape for the treatment of stress urinary incontinence in elderly women without concomitant pelvic organ prolapse: is it effective and safe?

OBJECTIVE: To evaluate the efficacy and safety of the transobturator approach (TVT-O) for the surgical management of stress urinary incontinence (SUI) in older women.

STUDY DESIGN: Between 2007 and 2010, all consecutive women with SUI undergoing an isolated TVT-O procedure were prospectively enrolled in this study. Patients were divided into two groups by age: older women (≥ 70 years old) were included in group 1, while younger women (< 70 years old) in group 2. Intra- and post-operative outcomes were compared between the groups.

RESULTS: During the study period 181 women met the inclusion criteria and were included for final analysis. Among these women, 60 (33.1%) and 121 (66.9%) were included in groups 1 and 2 respectively. After a median follow-up of 26 (IQR 15-41) months for the younger and 25 (IQR 18-40) months for older patients (p>0.99), no differences were observed between the two groups in terms of cure rate (92.5% vs. 88.3%; p=0.40). No differences were observed in terms of voiding dysfunction, vaginal erosion and persistent groin pain, or in terms of onset of de novo overactive bladder (9.0% vs. 13.3%; p=0.44).

CONCLUSIONS: TVT-O appears to be a safe and effective procedure for the management of stress urinary incontinence also in elderly population.