Evaluating the Impact of Valsalva Leak Point Pressure and Urge Incontinence on the Success of Transobturator Tape Surgery for Stress Urinary Incontinence

Objective: This study aimed to investigate factors influencing the surgical outcomes of patients undergoing transobturator tape (TOT) surgery for stress urinary incontinence (SUI), focusing on the predictive value of Valsalva Leak Point Pressure (VLPP) and the presence of urge incontinence. Material and Methods: A retrospective study was conducted involving 117 patients from 561 who underwent TOT surgery between May 2017 and March 2024. We excluded patients with prior pelvic surgeries or neurogenic bladder, and included SUI with urethral hypermobility as an inclusion criterion. We performed urodynamic testing, including VLPP measurement, preoperatively. Postoperative outcomes were evaluated using stress tests, the International Consultation on Incontinence Questionnaire- Short Form (ICIQ-SF), and assessments of urge incontinence and cystocele presence. Results: Postoperative stress tests revealed 14.5% failure and 85.5% success rates. We observed significant differences in urinary incontinence (UI) amount based on VLPP values (p = 0.001), where lower VLPP was associated with higher postoperative UI rates. Urge incontinence had a significant impact on postoperative UI (p = 0.023), but it did not correlate with preoperative UI frequency. Postoperatively, ICIQ-SF scores and impact on daily life showed significant improvement (p