The Effects of Suburethral Tape on the Symptoms of Overactive Bladder

Abstract

Suburethral tension-free vaginal tape is used for the treatment of stress urinary incontinence with a high success rate. Often patients report having stress incontinence, as well as co-existing micturition problems which are attributable to overactive bladder syndrome (OAB). The present study examines the effect of suburethral tape on the symptoms of OAB. In the study, we used the transobturator vaginal tape inside-out technique (TVT-O).
Materials and Methods: 53 patients were included in the study, all had proven urodynamic stress incontinence and symptoms of overactive bladder. The patients were examined preoperatively and 3 months after the TVT-O placement.
Results: The individual OAB symptoms improved significantly, with urinary frequency and urge incontinence improving more than nocturia. The frequency of micturition decreased on average from 16.1 to 10.1 episodes/24 hours, while nocturnal frequency of micturition decreased from 2.2 to 1.1. Not a single patient experienced the simultaneous worsening of all three measured variables, however 19 % of patients did report their simultaneous disappearance. Their quality of life that had been affected by OAB was measured on the basis of validated questionnaires, and found to have improved significantly. Only 28 % of patients reported a desire for drug treatment of OAB symptoms following tape placement.
Conclusions: TVT-O placement leads to a significant improvement of the symptoms of overactive bladder syndrome. Patient quality of life – which was affected by OAB – was also enhanced by the tape placement. This accounts for a substantial share of the overall success of the suburethral tape.

Zusammenfassung

Das spannungsfreie suburethrale Vaginalband wird zur Behandlung der Belastungsinkontinenz mit hohen Erfolgsraten eingesetzt. Oft berichten Patientinnen mit Belastungsinkontinenz aber auch von gleichzeitig bestehenden Miktionsproblemen, die dem Syndrom der überaktiven Harnblase (engl. overactive bladder – OAB) zuzuordnen sind. Die vorliegende Studie prüft die Wirkung des suburethralen Bandes auf die Symptome der OAB. In der Studie verwendeten wir ein transobturatorisch geführtes Band in der Inside-out-Technik (TVT-O).
Material und Methoden: In die Studie wurden 53 Patientinnen eingebracht, die alle außer einer urodynamisch nachgewiesenen Belastungsinkontinenz Symptome der überaktiven Harnblase aufwiesen. Die Patientinnen wurden präoperativ und 3 Monate nach Implantation von TVT-O untersucht.
Ergebnisse: Die einzelnen OAB-Symptome verbesserten sich signifikant, Dranginkontinenz und Pollakisurie mehr als Nykturie. Die Miktionsfrequenz sank im Mittel von 16,1 auf 10,1 Miktionen/24 Stunden, die nächtliche Miktionsfrequenz von 2,2 auf 1,1. Bei keiner einzigen Patientin kam es zur gleichzeitigen Verschlechterung aller 3 gemessenen Parameter, dafür jedoch bei 19 % der Patientinnen zu ihrem gleichzeitigen Verschwinden. Die durch die OAB beeinträchtigte Lebensqualität verbesserte sich signifikant, was anhand von validierten Fragebögen gemessen wurde. Nur 28 % der Patientinnen gaben nach Bandeinlage noch den Wunsch nach medikamentöser Behandlung der OAB-Symptome an.
Schlussfolgerungen: Die Implantation von TVT-O führt zur signifikanten Verbesserung der Symptome der überaktiven Harnblase. Auch die durch die OAB beeinträchtigte Lebensqualität wird durch die Bandimplantation gesteigert, was einen wesentlichen Anteil am allgemeinen Erfolg des suburethralen Bandes ausmachen dürfte.

Key words

urinary incontinence - urodynamics - overactive bladder - suburethral sling

Schlüsselwörter

Harninkontinenz - Urodynamik - überaktive Harnblase - suburethrales Band

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