ORIGINAL ARTICLE Sequential assessment of urodynamic findings before and after transobturator tape procedure for female urodynamic stress incontinence Sheng-Mou Hsiao & Bor-Ching Sheu & Ho-Hsiung Lin Received: 10 September 2007 / Accepted: 28 September 2007 / Published online: 11 October 2007 # International Urogynecology Journal 2007 Abstract The objective of this study was to sequentially compare the urodynamic findings of patients with urody- namic stress incontinence before and after transobturator tape procedure. Between May 2004 and December 2005, 26 of 34 consecutive patients with urodynamic stress incontinence who underwent transobturator tape procedure were enrolled. The sequential urodynamic findings of each case were compared and analyzed. Based on pad test, the cure and improvement rates were 69.2 and 30.8%, respectively. A significant increase in pressure transmission ratio at maximal urethral pressure at 1 year postoperatively (p =0.005) was observed after surgery. The improvement group (n =8) had significantly lower preoperative maximal urethral closure pressure (45.4 vs 68.2 mmHg, p =0.036) than did the cure group (n =18). The postoperatively increased pressure transmission ratio at maximal urethral pressure appears to contribute to its cure for urodynamic stress incontinence. Keywords Urodynamic study . Urodynamic stress incontinence . Pad test . Transobturator tape Introduction The tension-free vaginal tape (TVT) procedure for female stress urinary incontinence was first introduced by Ulmsten and Petros [1] in 1995 and shortly became known worldwide, with a cure rate of more than 80% [2]. As an alternative to the TVT procedure, the transobturator tape (TOT) outside-in technique was developed by Delorme [3] in 2001 to reduce the perioperative complications related to penetration of the retropubic space [4]. Several short-term studies reported high cure rates and low complication rates for TOT and discussed the responsible mechanism for the success of this treatment based only on preoperative urodynamic findings and postoperative clinical examination, uroflowmetry, and the cough test [4–8]. This study was aimed to investigate the correlation between urodynamic findings and TOT procedure by comparing urodynamic findings of patients with urodynamic stress incontinence (USI) before and at 3, 6, and 12 months after TOT. Materials and methods Between May 2004 and December 2005, 34 consecutive women with USI underwent TOT operation with insertion of Monarc transobturator tape (American Medical Systems, Minnetonka, MN, USA) at the Department of Obstetrics and Gynecology of National Taiwan University Hospital. The TOT was performed under intravenous general anesthesia in all cases. No concomitant surgery was performed in these 34 women with USI. All TOT procedures conformed to those described in previous reports [3, 4]. Ethical approval for the study was obtained from our research ethics committee in the hospital. A detailed patient history was recorded for each patient before physical examination and multichannel urodynamic study. The urodynamic assessment included a 20-min pad test [9–12], uroflowmetry, both filling (with a rate of 60 ml/min) and voiding cystometry with infusion of 35°C of distilled water, and stress urethral pressure profile (sUPP) with the Int Urogynecol J (2008) 19:627–632 DOI 10.1007/s00192-007-0488-4 S.-M. Hsiao : B.-C. Sheu : H.-H. Lin (*) Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, No. 7 Chung-Shan South Road, Taipei 100, Taiwan e-mail: hhlin@ntuh.gov.tw