Study of possibilities to improve the effectiveness of stress urinary incontinence treatment in menopausal women with an implanted TVT-O sling

The issue of urinary disorders in postmenopausal women is receiving significant attention due to its negative impact on quality of life, social activity, and the risk of emotional and sexual dysfunction. Aim: to investigate the potential for improving medium- and long-term outcomes of sling procedures for stress urinary incontinence using the transobturator placement of a prolene loop (TVT-Obturator, Tension-Free Vaginal Tape - Obturator, TVT-O) in combination with local estrogen therapy in postmenopausal women. Materials and methods. A comparative study was conducted to evaluate the immediate and long-term outcomes of sling procedures for surgical correction of stress urinary incontinence in menopausal women. The study included two representative groups. Group I (n=28): Patients underwent free synthetic loop plasty (TVT) for stress urinary incontinence. Group II (n=30): Patients underwent TVT-O and received a course of natural and semi-synthetic estrogens (promestriene). Statistical data analysis was performed using SPSS 21. Results. Two years post-surgery, patients in Group I had a significantly higher frequency of urgency and urge incontinence episodes compared to women in Group II. Additionally, the reduction in urinary incontinence episodes by ≥50% from baseline was significantly greater in Group II. At the two-year follow-up, a significantly higher number of women in Group II had a negative cough test and lower average pad weight. Moreover, the mean UDI-6 (Urogenital Distress Inventory) score in this group was significantly lower compared to Group I, indicating a more pronounced reduction in stress urinary incontinence symptoms. Conclusions. The results of a two-year follow-up of menopausal patients after surgical treatment of stress urinary incontinence demonstrated that TVT-O surgery, in combination with a postoperative course of natural and semi-synthetic estrogen therapy (promestriene), is statistically significantly more effective than TVT surgery alone. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors.