Transobturator tape combined with prasterone address both QoL and symptoms in overactive bladder

Italy: Transobturator tape (TOT) procedure combined with prasterone (TOT-P) reduces urgency and overactive bladder symptoms as effectively as TOT combined with solifenacin (TOT-S) in postmenopausal women with mixed urinary incontinence (MUI), a recent study has found.

Post-TOT-P also significantly improves vaginal health index (VHI) scores and sexual function. VHI includes measures of vaginal atrophy. The findings by the Italian researchers were published in Lower Urinary Tract Symptoms on Mar 04 2023.

“In postmenopausal women, TOT-P should be considered for treating mixed urinary incontinence symptoms driven by stress urinary incontinence (SUI),” the investigators suggested.

Giorgia Cardella, University Tor Vergata, Rome, Italy, and colleagues conducted the study to compare the efficacy of the post-transobturator tape use of prasterone or TOT followed by solifenacin in postmenopausal women affected by mixed urinary incontinence with a predominant stress urinary incontinence component in a retrospective analysis.

To investigate the impact on women’s sexual function and quality of life, specific questionnaires were administered. The study included 112 patients: 60 in the TOT-S group and 52 in the TOT-P group. The following parameters were compared at the beginning of the analysis and after 12 weeks of follow-up — 3-day voiding diary, physical examination, Vaginal Health Index (VHI), and urodynamic tests.

The study revealed the following findings:

After 12 weeks of FU, the detrusor’s peak flow pressure significantly differed between the two groups.Detrusor overactivity decreased only in the TOT-P group.At the end of FU, 96.7% of TOT-S and 96.2% of TOT-P group patients were dry at the stress test.A significative group difference was observed in urge urinary incontinence (24 h) but not in the mean number of voids (24 h) and urgent micturition events (24 h). VHI improved only in the TOT-P group (12.57 ± 3.80 versus 19.75 ± 4.13).The questionnaires and Patient Global Index of Improvement (PGI-I) scores showed comparable improvements, while the Female Sexual Function Index improved, especially in the TOT-P group.

To conclude, TOT-P showed the same effectiveness as TOT-S in reducing urinary symptoms among postmenopausal women with MUI. In addition, TOT-P increased vaginal health index and sexual function scores compared to TOT-S.


Sala F, Loggia M, Cardella G, Morgani C, Grossi G, Zullo MA, Valensise HCC, Palazzetti PL, Schiavi MC. TOT in combination with solifenacin or intravaginal prasterone in postmenopausal women with mixed urinary incontinence: A retrospective analysis in 112 patients. Low Urin Tract Symptoms. 2023 Mar 04 [Epub ahead of print]. doi: 10.1111/luts.12476. PMID: 36869670

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