RESUMO
Background: Urinary incontinence has an estimated incidence of 25-50% in the adult female population. It has a profound physical and psychosocial impact, compromising women抯 quality-of-life (QoL). The suburethral sling is currently considered the surgical treatment of choice for stress urinary incontinence (SUI). The present study aimed to evaluate the impact of urinary incontinence on women抯 QoL before and after transobturator suburethral sling surgery, as well as the effectiveness of surgical treatment.Methods: A prospective longitudinal, observational and analytical study was performed between June and December 2021. The study population included 64 women with urinary incontinence, to whom the King's Health Questionnaire (KHQ) was applied, before and after surgery.Results: Of the 64 women included in the study, 59.4% (n=38) had SUI and 40.6% (n=26) had mixed urinary incontinence (MUI). There was an improvement in the global KHQ score in 96.9% (n=62) of subjects, with a statistically and clinically significant impact on QoL (p<0.001). Patients with MUI had higher preoperative KHQ global scores, reflecting a more substantial impact on their QoL. Surprisingly, postoperative improvement in QoL was equally significant, both clinically and statistically (p<0.001), with no differences when comparing to isolated sui patients (p>0.05).Conclusions: QoL assessment questionnaires help to quantify individual impact of urinary incontinence and identify which patients benefited most from treatment. This study not only enhances our understanding of the true impact of urinary incontinence on QoL, but also emphasizes the effectiveness and importance of this minimally invasive surgery in improving the QoL of patients with SUI as well as MUI.
RESUMO
This case report presents a rare complication of tension-free mid-urethral tape surgery by the obturator approach (TOT) in the form of a urethro-cutaneous fistula. The patient underwent successful surgical repair, highlighting the importance of intraoperative cystoscopy to minimize surgical risks and complications. Tension-free mid-urethral tape surgery is a commonly performed procedure for the treatment of stress urinary incontinence (SUI). However, complications can occur, albeit rarely. In this case, a 52-year-old female patient developed a urethro-cutaneous fistula following TOT surgery. The fistula was identified by the presence of urine leakage at the right inguinal level, leading to significant distress and discomfort for the patient. Prompt diagnosis and appropriate management are crucial in such cases. The patient underwent surgical repair, which involved excision of the fistulous tract. The procedure was successful, resulting in complete resolution of the fistula and restoration of normal urinary function. In conclusion, this case report highlights the occurrence of a rare complication, namely a urethro-cutaneous fistula, following TOT surgery. The successful surgical repair emphasizes the importance of prompt diagnosis and appropriate management. Furthermore, the authors propose that an intraoperative cystoscopic evaluation be considered, even after a TOT procedure. Especially in cases that present risk factors or in hospital-school institutions. By implementing this practice, surgeons can enhance patient safety and improve surgical outcomes in anti-incontinence procedures.