Trans-Obturator Tension Appliance Tape for failed Mid-Urethral Sling when and how?

Background & Objectives: Female urinary incontinence is a significant health issue affecting adult women, most suffering from stress incontinence. It affects the quality of life. Recurrence after surgery is difficult for the patients and the surgeon. There is no precise data to show how to treat failed Transobturator tape. Transobturator tape with tension may be an alternative method in applying proper tension in the mid urethra to correct the incontinence. We describe our experience to evaluated outcomes of the second mid-urethral sling with tension to treat recurrent incontinence after the failure of the first mid-urethral sling. Methods: A prospective cohort study was conducted between Oct. 2012 to March 2019. A total of 16 patients with failed Transobturator tape surgery underwent second trans-obturator Mid-Urethral Sling surgery. Preoperative data and postoperative complications were recorded. All patients were followed for one year. Results: Sixteen women after failed Mid-Urethral Sling surgery were evaluated. At a mean follow-up of 7.5 months, the cure rate was 62.5% (10 out of 16) patients. Partial cure (improvement) was achieved in 25% ( 4 patients out of 16) and failure in 2 patients, 12.5%. There were statistically significant improvements after surgery in the Q-tip test and the number of the pads. Conclusion: Repeat Transobturator tape with tension treatment tends to result in good outcomes with a reasonable physician-determined success rate.