Outcomes of Transobturator Tape Surgery for Stress and Mixed Urinary Incontinence: A 12-Year Retrospective Review

<b>Background</b>: Stress urinary incontinence (SUI) and mixed urinary incontinence (MUI) are common disorders that impair quality of life. While transobturator tension-free vaginal tape (TVT-O) is established for SUI, outcomes in MUI remain uncertain. <b>Methods</b>: We analyzed 111 women who underwent TVT-O at Keelung Chang Gung Memorial Hospital. Baseline data included demographics, Overactive Bladder Symptom Score (OABSS), uroflowmetry [peak flow rate (PFR), residual urine (RU)], and Pelvic Organ Prolapse Quantification (POP-Q) stage. The primary outcome was OABSS improvement (≥1-point reduction); secondary outcomes were longitudinal OABSS, uroflowmetry, pad usage, and POP-Q stage. <b>Results</b>: At 3 months, 31.5% (35/111) met responder criteria. Symptom improvement occurred more often in MUI than in SUI, with about half of women with MUI (48.6%) and one quarter of those with SUI (27.4%) reporting subjective improvement (<i>p</i> = 0.018). OABSS improved in MUI (7.92 → 7.18, <i>p</i> = 0.001) but worsened in SUI (6.84 → 7.52, <i>p</i> < 0.001). In SUI, PFR increased (<i>p</i> = 0.001) and RU decreased (<i>p</i> = 0.029); no significant changes occurred in MUI. MUI independently predicted response (OR, 2.59; 95% CI, 1.10-6.14) and greater ΔOABSS (β = -1.391, <i>p</i> < 0.001); higher baseline OABSS also predicted improvement (β = -0.093, <i>p</i> = 0.049). For pad usage, MUI was associated with persistence (OR, 3.855, <i>p</i> = 0.010). ROC analysis showed modest discrimination for MUI (AUC 0.626, <i>p</i> = 0.034). <b>Conclusions</b>: TVT-O provided symptom relief, with about half of the women with MUI, and one quarter of those with SUI experienced subjective improvement. Women with MUI and higher baseline OABSS were more likely to improve, but these findings should be interpreted with caution, given the modest sample size.