JCU - Abstracts of the BAUS 2018 Scientific Meeting - June 2018 - 55

Abstracts

P5-12: Table 1. Participant characteristics of the two treatment groups.

is 18 (11−28) months. The APOPR was performed using
10−18 cm of rectus sheath with similar technique to that
employing mesh to support the anterior−posterior vaginal walls or encircle the cervix and secured to the sacral
promontory.
Results: Results are summarized in Figure 1. All patients
have durable result at last follow up.
Conclusions: This is the first description in Europe of
APOPR. This series demonstrates feasibility of this technique with successful medium−term outcomes. APOPR
avoids the 10−15% risks of mesh−related complications.
APOPR and has the potential of a cost−effective and safe
alternative for women who wish to avoid mesh. Further
studies of long−term durability are needed.
P5-13 Still safe and successful? Longterm
results of 100 consecutive transobturator
tapes
Croghan S1, MacCraith E1, Costigan G, Niall O1,
Lennon G1
1St. Vincent's Hospital Group, Dublin, Ireland

Introduction: Whilst the transobturator tape (TOT) has
demonstrated good results at short term follow-up, a lack
of long-term outcome data is recognised. We aimed to
assess long-term outcomes of TOTs and ascertain whether
preoperative urodynamics predicted outcome.
Patients & Methods: A retrospective review of 100
TOTs inserted for stress/mixed UI over a 5-year period

was performed. A single surgeon assessed and operated
on all patients. Pre-operative investigations (uroflow, cystometrogram, cystoscopy & stress test) and post-procedure urodynamics were recorded. Patients (now >7 years
post-procedure) were posted ICIQ Short-Form, PGI-S
and PGI-I questionnaires for completion. Complications
were recorded.
Results: 100 patients were included, mean age 51.7 years
(33-75), mean follow-up 9.25 years (7.5 - 12.75). Clinically,
68/100 had mixed-UI. 32/100 had clinical pure SUI, with
CMG detrusor overactivity in 8/32 (25%). Clinical and
urodynamic cure/significant improvement in SUI was seen
in 98/100 and 93/100 respectively. 50/68 (73.53%) mixedUI patients reported cure/improvement of urge incontinence at 2 months. De-novo clinical urgency/detrusor
instability arose in 2/100. Of contactable patients, questionnaire response rate was 60/85 (70.59%). Mean ICIQ
score was 8.58 (1-20). 52/60 (86.67%) described current
urinary condition as "much better" or "very much better"
than prior to surgery. Grade 3b Clavien-Dindo complications occurred in 9/100; all apparent within 6 months of
surgery. Correlations (Pearson r) between pDetQMax
and post-operative uroflow/duration ISC, or between preoperative leak-point pressures and outcome were not
significant.
Conclusions: TOTs demonstrate high success rates in
urodynamic and patient reported cure of stress/mixed-UI,
with a low complication rate at long-term follow-up.
Recent controversies surrounding use of pelvic mesh
make this data particularly pertinent.

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