{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T07:25:36Z","timestamp":1789802736978,"version":"4.0.1"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,8,19]],"date-time":"2022-08-19T00:00:00Z","timestamp":1660867200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST 109-2320-B-715-005 MOST 108-2320-B-715-002-MY3 108-2314-B-715-004-MY3 MOST 110-2320-B-038-042 108-2320-B-038-028"],"award-info":[{"award-number":["MOST 109-2320-B-715-005 MOST 108-2320-B-715-002-MY3 108-2314-B-715-004-MY3 MOST 110-2320-B-038-042 108-2320-B-038-028"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Bioeng. Biotechnol."],"abstract":"<jats:p><jats:bold>Importance:<\/jats:bold> It needs to be clarified whether trans-obturator tape (TOT)-enhanced urethral resistance could impact the voiding function.<\/jats:p><jats:p><jats:bold>Objective:<\/jats:bold> Although TOT has been well-recognized for enhancing urethral resistance to restore continence in stress urinary incontinence (SUI) patients, whether the bladder\u2019s voiding functions adapt to the TOT-enhanced resistance has not been adequately investigated. This study thereby aimed to investigate whether TOT impacts the bladder\u2019s thermodynamic efficacy during the voiding phase.<\/jats:p><jats:p><jats:bold>Design:<\/jats:bold> A retrospective analysis of urodynamics performed before and after TOT was assessed.<\/jats:p><jats:p><jats:bold>Setting:<\/jats:bold> A tertiary referral hospital in Taiwan.<\/jats:p><jats:p><jats:bold>Participants:<\/jats:bold> A total of 26 female SUI patients who underwent urodynamic investigations before and after TOT.<\/jats:p><jats:p><jats:bold>Main outcomes and measures:<\/jats:bold> The area enclosed by the pressure-volume loop (Apv), which represents the work performed by the bladder during voiding, in a pressure-volume analysis established by plotting the detrusor pressure versus intra-vesical volume was retrospectively analyzed. Paired Student\u2019s <jats:italic>t<\/jats:italic>-tests were employed to assess the difference in values before and after the operation. Significance in difference was set at <jats:italic>p<\/jats:italic> &amp;lt; 0.05.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> TOT increased Apv in 20 of 26 (77%) patients and significantly increased the mean Apv compared to the preoperative control (2.17 \u00b1 0.18 and 1.51 \u00b1 0.13 \u00d7 10<jats:sup>3<\/jats:sup> cmH<jats:sub>2<\/jats:sub>O-ml, respectively <jats:italic>p<\/jats:italic> &amp;lt; 0.01). TOT also increased the mean urethral resistance (1.03 \u00b1 0.30 vs. 0.29 \u00b1 0.05 cmH2O-sec\/ml, <jats:italic>p<\/jats:italic> &amp;lt; 0.01) and mean voiding pressure (25.87 \u00b1 1.72 and 19.30 \u00b1 1.98 cmH2O <jats:italic>p<\/jats:italic> &amp;lt; 0.01) but did not affect the voided volume and voiding time. Moreover, the TOT-induced Apv increment showed a moderate correlation with the changes in urethral resistance and voiding pressure (both <jats:italic>r<\/jats:italic> &amp;gt; 0.5) but no correlation with changes in voided volume or voiding time. It is remarkable that the TOT-induced urethral resistance increment showed a strong correlation with changes in voiding pressure (<jats:italic>r<\/jats:italic> &amp;gt; 0.7).<\/jats:p><jats:p><jats:bold>Conclusion and Relevance:<\/jats:bold> The bladder enhances thermodynamic efficacy by adapting the voiding mechanism to increased urethral resistance caused by TOT. Further studies with higher case series and longer follow-ups should assess whether this effect could be maintained over time or expire in a functional detrusor decompensation, to define diagnostic criteria that allow therapeutic interventions aimed at its prevention during the follow-up.<\/jats:p><jats:p><jats:bold>Clinical Trial Registration:<\/jats:bold> (<jats:ext-link>clinicaltrials.gov<\/jats:ext-link>), identifier (NCT05255289)<\/jats:p>","DOI":"10.3389\/fbioe.2022.912602","type":"journal-article","created":{"date-parts":[[2022,8,19]],"date-time":"2022-08-19T05:14:23Z","timestamp":1660886063000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Modification of bladder thermodynamics in stress urinary incontinence patients submitted to trans-obturator tape: A retrospective study based on urodynamic assessment"],"prefix":"10.3389","volume":"10","author":[{"given":"Hui-Hsuan","family":"Lau","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng-Yuan","family":"Lai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsien-Yu","family":"Peng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Chun","family":"Hsieh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsung-Hsien","family":"Su","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie-Jen","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tzer-Bin","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,8,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/s0090-4295(02)02243-4","article-title":"The standardisation of terminology in lower urinary tract function: Report from the standardisation sub-committee of the international continence society","volume":"61","author":"Abrams","year":"2003","journal-title":"Urology"},{"key":"B2","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1002\/nau.10052","article-title":"The standardisation of terminology of lower urinary tract function: Report from the standardisation sub-committee of the International Continence Society","volume":"21","author":"Abrams","year":"2002","journal-title":"Neurourol. 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