Quality of life outcomes after transobturator tape full removal surgeries: A monocentric experience.

Abstract

<h4>Objective</h4>The objective of this study is to describe a standardised technique of full TOT removal with groin dissection and to report clinical improvement, satisfaction, safety and long-term functional, quality of life (QoL) and sexual QoL outcomes.<h4>Materials and methods</h4>A retrospective review enrolling all women who had full TOT removal, in a tertiary referral centre from May 2017 to November 2020. Functional outcomes, satisfaction and QoL were assessed using a bespoke composite questionnaire (UDI-6, EQ-5D-5L and ICIQ-S) with additional questions on sexual QoL. Secondary outcomes were post-operative recurrent stress urinary incontinence (SUI) and complication rate according to the Clavien-Dindo classification.<h4>Results</h4>Full TOT removal using a vaginal approach and bilateral groin/para-labial incisions was performed in 67 patients. Chronic pelvic pain was the main indication for mesh removal (51% of cases, <i>n</i> = 34). QoL questionnaires were answered by 43 patients. The satisfaction rate was high 86% (<i>n</i> = 37), and 81% (<i>n</i> = 35) of the patients considered the surgery successful. Seventy per cent (<i>n</i> = 30) of patients returned to having a sexual life after surgery. Recurrent SUI was reported in 32% (<i>n</i> = 14) of cases. The complication rate was 10% (7/67), all of them Clavien-Dindo ≤2.<h4>Conclusion</h4>Despite a high rate of postoperative bothersome SUI, full TOT removal with bilateral groin dissection improves pain and QoL. It is associated with a high overall satisfaction rate and an acceptable rate of complications.