{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:51:44Z","timestamp":1786978304005,"version":"build-2736575974"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,2,24]],"date-time":"2023-02-24T00:00:00Z","timestamp":1677196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Midurethral tapes (MUTs) were the most common surgical treatment for stress urinary incontinence (SUI) between 2008 and 2017. Transobturator tapes were introduced as a novel way to insert MUTs. Some women have experienced life\u2010changing complications, and opt to undergo a total excision of transobturator tape (TETOT). There is a paucity in evidence about the outcomes of TETOT, which is a complex operation. This study aims to report clinical outcomes of all women who underwent TETOT in a specialist mesh center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All women between 2017 and 2022 who underwent TETOT in one mesh center were reviewed. Background demographics and preoperative symptoms were recorded retrospectively. Outcome data were collected using\u00a0patient global impression of improvement (PGI\u2010I) scales via telephone review and analyzed using SPSS 25.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty\u2010five women underwent telephone review in May 2022, on average 27.9 months (range: 3\u221260) after TETOT. Mean age was 55 and body mass index (BMI): 30; 82% were postmenopausal, 20% were smokers, and 73.3% had recurrent SUI before excision. Indications for excision were infection (4%), vaginal exposure (24%), urethral perforation (9%), and chronic pain not associated with other complications (60%). Two women with recurrent SUI opted for a concomitant fascial sling; both reported a PGI of \u201cvery much improved\u201d regarding SUI postoperatively. Only 12 women (26.5%) did not have SUI before excision; of these 9 (75%) reported new SUI postoperatively. Pain improved for 57.8%, but worsened for 24.4%. Although not statistically significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.055), more women who underwent TETOT for pain alone reported worsening pain than those with pain with an additional complication (37% vs. 5.55%). Overall, 62.2% women felt \u201cbetter\u201d after their excision, 17.8% felt \u201cworse.\u201d\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>After TETOT, 62% of women felt better. Improvement in pain was reported by 58%\u2014those with chronic pain without another complication reported improvement in pain less frequently (48% vs. 72%) and worsening pain more frequently (37% vs. 6%). Existing SUI worsened in 65% of women and 75% developed new SUI. There appears to be discordance between reporting global improvement with worsening of commonly measured clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Outcome data are important for counseling women about the risks and benefits of TETOT. Women and clinicians may have different attitudes to the possible benefits of TETOT, as evidenced by women reporting feeling better despite continuing pain or SUI. Conventional outcome measures do not adequately capture all outcomes that are important to patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/nau.25155","type":"journal-article","created":{"date-parts":[[2023,2,24]],"date-time":"2023-02-24T03:13:48Z","timestamp":1677208428000},"page":"785-793","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Clinical outcomes after total excision of transobturator tape inserted for treatment of stress urinary incontinence"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1267-8049","authenticated-orcid":false,"given":"Nazish","family":"Abbas","sequence":"first","affiliation":[{"name":"Warrell Unit, Saint Mary's Hospital Manchester University NHS Foundation Trust  Manchester UK"},{"name":"Manchester Academic Health Science Centre Manchester UK"},{"name":"Faculty of Biology, Medicine and Health University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tonicka","family":"Virdee","sequence":"additional","affiliation":[{"name":"The School of Medical Sciences University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maya","family":"Basu","sequence":"additional","affiliation":[{"name":"Warrell Unit, Saint Mary's Hospital Manchester University NHS Foundation Trust  Manchester UK"},{"name":"Manchester Academic Health Science Centre Manchester UK"},{"name":"Faculty of Biology, Medicine and Health University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Iles","sequence":"additional","affiliation":[{"name":"Warrell Unit, Saint Mary's Hospital Manchester University NHS Foundation Trust  Manchester UK"},{"name":"Manchester Academic Health Science Centre Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surya","family":"Kanitkar","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Manchester University NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohna","family":"Kearney","sequence":"additional","affiliation":[{"name":"Warrell Unit, Saint Mary's Hospital Manchester University NHS Foundation Trust  Manchester UK"},{"name":"Manchester Academic Health Science Centre Manchester UK"},{"name":"Faculty of Biology, Medicine and Health University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamayun","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Manchester University NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Ward","sequence":"additional","affiliation":[{"name":"Warrell Unit, Saint Mary's Hospital Manchester University NHS Foundation Trust  Manchester UK"},{"name":"Manchester Academic Health Science Centre Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Reid","sequence":"additional","affiliation":[{"name":"Warrell Unit, Saint Mary's Hospital Manchester University NHS Foundation Trust  Manchester UK"},{"name":"Manchester Academic Health Science Centre Manchester UK"},{"name":"Faculty of Biology, Medicine and Health University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,2,24]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01902378"},{"issue":"6","key":"e_1_2_11_3_1","first-page":"1306","article-title":"[Transobturator urethral suspension: mini\u2010invasive procedure in the treatment of stress urinary incontinence in women]","volume":"11","author":"Delorme E","year":"2001","journal-title":"Prog Urol"},{"key":"e_1_2_11_4_1","unstructured":"NHS Digital.\u00a0Official Statistics: Retrospective review of surgery for Vaginal prolapse and stress urinary incontinence using tape or mesh.2018. Available online:http:\/\/digital.nhs.uk\/catalogue\/PUB30267"},{"issue":"7","key":"e_1_2_11_5_1","article-title":"Mid\u2010urethral sling operations for stress urinary incontinence in women","author":"Ford AA","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_11_6_1","unstructured":"The Independent Medicines & Medical Devices Safety Review.2018.http:\/\/www.immdsreview.org.uk\/news.html. Accessed May 21 2019."},{"key":"e_1_2_11_7_1","unstructured":"NHS Improvement NHS England. Letter to acute trust CEOs and medical directors.;2018.\u00a0Avaiable from:https:\/\/bsug.org.uk\/budcms\/includes\/kcfinder\/upload\/files\/47560_embargoed-to-00-01-10-july-2018-mesh-letter-to-acute-ceos-and-mds.pdf"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-019-03973-2"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16778"},{"key":"e_1_2_11_10_1","first-page":"1","article-title":"Total trans\u2010obturator tape (TOT) removal; a case series including pain and urinary continence outcomes","volume":"1","author":"Shawer S","year":"2022","journal-title":"Int Urogynecol J"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2014.04.006"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-014-2455-1"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-018-3756-6"},{"key":"e_1_2_11_14_1","doi-asserted-by":"crossref","unstructured":"NICE Guidelines. Urinary incontinence and pelvic organ urinary incontinence and pelvic organ prolapse in women: management prolapse in women: management [NG123];2019.\u00a0Available from:www.nice.org.uk\/guidance\/ng123","DOI":"10.1111\/bju.14763"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2003.379"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.14225"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.2337\/db20-199-LB"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.01.048"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.14997"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/2090598X.2019.1589787"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/luts.12263"},{"key":"e_1_2_11_22_1","first-page":"9","article-title":"Recurrent incontinence after transvaginal partial sling excision in patients with prior mid\u2010urethral sling","volume":"13","author":"Shapiro R","year":"2021","journal-title":"Res Rep Urol"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2012.11.013"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2017.01.060"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000042"},{"issue":"10","key":"e_1_2_11_26_1","first-page":"139","article-title":"HHS public access","volume":"176","author":"Nussinov","year":"2017","journal-title":"Physiol Behav"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1185\/03007995.2013.810615"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1185\/03007995.2016.1157460"}],"container-title":["Neurourology and Urodynamics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nau.25155","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/nau.25155","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nau.25155","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T05:49:32Z","timestamp":1695620972000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/nau.25155"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,24]]},"references-count":27,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,4]]}},"alternative-id":["10.1002\/nau.25155"],"URL":"https:\/\/doi.org\/10.1002\/nau.25155","archive":["Portico"],"relation":{},"ISSN":["0733-2467","1520-6777"],"issn-type":[{"value":"0733-2467","type":"print"},{"value":"1520-6777","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,24]]},"assertion":[{"value":"2022-11-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}