Published: 2019-11-26

The role of trans obturator tape as a surgical procedure for female stress urinary incontinence and its impact on quality of life in Jammu region

Sapna Puri, Manisha Kohli


Background: Stress incontinence is one of the most common but debilitating health issue among women. It has a detrimental effect on overall health and quality of life of women. Trans obturator tape (TOT) has emerged as a promising treatment modality. The aim of present study was to assess the usefulness of TOT in terms of change in quality of life of stress incontinence patients.

Methods: The study was performed at Department of Obstetrics and Gynecology, Acharya Shri Chandler of Medical Sciences (ASCOMS), Jammu. A total of 50 symptomatic women were enrolled in the study and underwent TOT procedure using outside-in technique. The quality of life of women was assessed at enrolment and 12 months after the procedure using King’s Health Questionnaire (KHQ). Change in QOL was assessed using paired ‘t’-test.

Results: After 12 months follow-up, a total of 27 (54%) patients were entirely symptom free. As compared to pre-treatment QOL assessment on KHQ for general health/incontinence impact, quality of life and symptom scores a % decline of 73.2%, 79.8% and 78.4% was observed. For all the three parts, the change in scores was significant statistically. No other complications and side effects were reported.

Conclusions: TOT is a useful procedure which provided symptomatic relief as well as QOL enhancement.


King’s health questionnaire, Quality of life, Stress incontinence, Symptom score, Trans obturator tape

Full Text:



Aoki Y, Brown HW, Brubaker L, Cornu JN, Daly JO, Cartwright R. Urinary incontinence in women. Nat Rev Dis Primers. 2017;3:17042.

Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J. An International urogynecological association (IUGA)/International continence society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29:4-20.

Hampel C, Weinhold D, Benken N Eggersmann C, Thuroff JW. Definition of overactive bladder and epidemiology of urinary incontinence. Urol. 1997;50:4.

Hampel C, Artibani W, Espuña Pons M, Haab F, Jackson S, Romero J, et al. Understanding the burden of stress urinary incontinence in Europe: A qualitative review of the literature. Eur Urol. 2004;46:15.

Tennstedt SL, Fitzgerald MP, Nager CW, Xu Y, Zimmern P, Kraus S, et al. Quality of life in women with stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18(5):543-9.

Ganapathy T. Impact of urinary incontinence on quality of life among rural women. Muller J Med Sci Res. 2018;9:71-7.

Rovner ES, Wein AJ. Treatment options for stress urinary incontinence. Rev Urol. 2004;6 Suppl 3(Suppl 3):S29-S47.

Magon N, Chopra SV. Transobturator tape in treatment of stress urinary incontinence: it is time for a new gold standard. N Am J Med Sci. 2012;4(5):226-30.

Reese PR, Pleil AM, Okano GJ, Kelleher CJ. Multinational study of reliability and validity of the King’s Health questionnaire in patients with overactive bladder. Qual Life Res. 2003;12(4):427-42.

Hebbar S, Pandey H, Chawla A. Understanding King’s Health Questionnaire (KHQ) in assessment of female urinary incontinence. Int J Res Med Sci. 2015;3(3):531-8.

Luber KM. The definition, prevalence, and risk factors for stress urinary incontinence. Rev Urol. 2004;6 Suppl 3(Suppl 3):S3-S9.

Guin G, Choudhary A, Dadhich R. Prevalence of stress urinary incontinence and its associated risk factors amongst females attending tertiary referral centre. Int J Reprod Contracept Obstet Gynecol. 2018;7(6):211-9.

Celada P, Cañete P, Ortiz Murillo E, Tarín JJ, Cano A. Effectiveness and quality of life 10 years after transobturator suburethral tape surgery for stress urinary incontinence. J Obstet Gynaecol Res. 2018;44(3):518-23.

Paul F, Joce AP, Giridhar A, Mampatta J, Shetty S, Bhat S. Impact of transobturator tape procedure on quality of life in female stress urinary incontinence. Int J Anat Radiol Surg. 2017;6(1):SO06-9.

Aygül C, Özyurt R, Şık BA, Kumbasar S. Evaluation of the efficacy of transobturator tape surgery in the treatment of stress urinary incontinence using urodynamics and questionnaires. Turk J Obstet Gynecol. 2016;13(4):172-7.

Jacob KJ, Jayaprakash M, Cherian A. Quality of life assessment in women with stress urinary incontinence following Trans Obturator Tape (TOT) insertion: a prospective study. Int J Reprod Contracept Obstet Gynecol. 2017;6(10):4508-10.

Jose D, Zoff F, Modotti CG. An evaluation of the outcome and quality of life after TOT-surgery. Int J Obstet Gynaecol. 2016;4(1):117-22.