Evaluation of patients who underwent transobturatory tape operation i̇n our clinic i̇n the last 10 years and long-term results

Aim: Various treatment options have been tried to determine the most appropriate method for the treatment of stress urinary incontinence, but a definitive standard treatment method has not yet been established. The aim of this study is to investigate the efficacy and safety of transobturatory tape surgery in female patients with stress urinary incontinence. In addition, we aim to evaluate the long-term results of the patients admitted to our clinic after the operation, determine the standard treatment procedures for our patients and provide treatment. Materials and Methods: January Dec 2013 to January 2023, 68 patients among 95 patients who were admitted to the Obstetrics and Gynecology outpatient clinic of Harran University Faculty of Medicine Hospital with urinary incontinence and underwent TOT operation by being diagnosed with stress urinary incontinence (SUI) were included in the study.Sociodemographic characteristics of patients (age,), clinical characteristics gravida, parity, mode of delivery,normal number of births , number of cesarean sections, total number of births , preop/postop hb levels, time elapsed after surgery, weight, type of concomitant surgery in the same session , preop/postop physical examination, it includes whether there are comorbidities, smoking, postoperative urinary incontinence complaints, intraoperative complications, postoperative complications, preop/postop stress test, preop/postop day and night urine counts. All patients were re-reached by phone during the postoperative period and the results were compared by taking into account their preoperative and postoperative current conditions. The Statistical Package For Social Sciences (27.0 package program) program was used for statistical analyses. Results: A total of 68 patients with an average age of 44.5 years (22-69) were included in our study (Table 2). The postoperative follow-up periods of the patients ranged between 1-10 years; the average follow-up period was 6 years (1-10). Dec. The average number of gravida of patients is 6(1.11), the average of parity is 5(0.10), the average number of births is 5(0.10). The average weight of the patients was 78 kg (64.90). While 48 of the patients had no systemic disease, 20 patients had additional systemic disease. October 20, 20 patients had systemic disease. Within the scope of the indication, additional surgery was performed on 63 (92.6% ) patients in the same session. Oct. The mean preoperative hemogram value of the patients was 13.2±1.2, while postoperative hemogram value was 11.7±1.2. The decrease in hemoglobin value was statistically significant (p<0.000). When patients were evaluated for changes in postoperative urinary incontinence complaints, 4 (5.9%) patients reported an increase in complaints, 9 patients (13.2% ) had a decrease in complaints, 4 patients (5.9% ) had no change in complaints, 51 patients (75% ) stated that their complaints had completely passed. In terms of complaints, if patients whose complaints have decreased and passed completely in the evaluation are considered successful, the operation was successful in 60 (88.2% ) patients, if patients whose complaints are the same and increasing are considered unsuccessful, the operation was unsuccessful in 8 (11.2% ) patients. The stress test was found positive in 66 (97.1%) of the patients before the operation, while it was found negative in 2 (2.9%). In the postoperative period, the stress test was found negative in 52 (76.4%) of the patients, while it was found positive in 16 (23.6%). The improvement in the postoperative stress test was statistically significant. The condition of the night postoperative period compared to the preoperative period, and this difference was not statistically significant(<0.547).The average number of daytime urination was the condition in the postoperative period compared to the preoperative period, and this difference was statistically significant (p<0.000). Conclusion: When we look at the long-term results of patients, it is seen that TOT surgery is an effective treatment method. Keywords: Stress urinary incontinence, Midüretral sling operation, Tot,