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Introduction and Hypothesis <p>To compare short-term outcomes of pubourethral ligament plication (PLP) versus transobturator tape (TOT) for stress urinary incontinence (SUI) and evaluate the prognostic value of the preoperative International Consultation on Incontinence Questionnaire–Short Form (ICIQ-SF).</p> Methods <p>In this prospective, non-randomized cohort study, 140 women underwent PLP (<i>n</i> = 48) or TOT (<i>n</i> = 92). Success was assessed at 6&#xa0;months using objective (pad count) and subjective criteria. Predictive performance of preoperative ICIQ-SF was analyzed using receiver operating characteristic (ROC) curves.</p> Results <p>Preoperative symptoms were more severe in the TOT group (<i>p</i> = 0.003). Objective success rates were 88.0% for TOT and 77.1% for PLP (<i>p</i> &gt; 0.05); subjective satisfaction was high and comparable. PLP had significantly shorter operative duration (<i>p</i> &lt; 0.001) and no mesh-related complications, while TOT had an 8.7% complication rate. Preoperative ICIQ-SF score demonstrated excellent discriminative power for predicting failure (AUC 0.98; 95% CI 0.96–1.00), whereas daily pad count was a poor predictor (AUC 0.48). An ICIQ-SF threshold of ≥ 17 points identified patients at high risk of failure with high sensitivity and specificity.</p> Conclusions <p>PLP and TOT provide comparable short-term relief. PLP is a faster, mesh-free alternative avoiding synthetic material-related morbidity. Preoperative ICIQ-SF is a robust tool for individualized risk stratification, though the high AUC warrants external validation.</p>

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Beyond the Mesh: PuboUrethral Ligament Plication Versus Transobturator Tape at 6 Months and the Power of Preoperative ICIQ-SF for Risk Stratification

  • 期刊论文

  • 发表日期：

    2026年2月7日

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  • Mehmet İncebıyık,
  • İbrahim Halil Adak

摘要

Introduction and Hypothesis

To compare short-term outcomes of pubourethral ligament plication (PLP) versus transobturator tape (TOT) for stress urinary incontinence (SUI) and evaluate the prognostic value of the preoperative International Consultation on Incontinence Questionnaire–Short Form (ICIQ-SF).

Methods

In this prospective, non-randomized cohort study, 140 women underwent PLP (n = 48) or TOT (n = 92). Success was assessed at 6 months using objective (pad count) and subjective criteria. Predictive performance of preoperative ICIQ-SF was analyzed using receiver operating characteristic (ROC) curves.

Results

Preoperative symptoms were more severe in the TOT group (p = 0.003). Objective success rates were 88.0% for TOT and 77.1% for PLP (p > 0.05); subjective satisfaction was high and comparable. PLP had significantly shorter operative duration (p < 0.001) and no mesh-related complications, while TOT had an 8.7% complication rate. Preoperative ICIQ-SF score demonstrated excellent discriminative power for predicting failure (AUC 0.98; 95% CI 0.96–1.00), whereas daily pad count was a poor predictor (AUC 0.48). An ICIQ-SF threshold of ≥ 17 points identified patients at high risk of failure with high sensitivity and specificity.

Conclusions

PLP and TOT provide comparable short-term relief. PLP is a faster, mesh-free alternative avoiding synthetic material-related morbidity. Preoperative ICIQ-SF is a robust tool for individualized risk stratification, though the high AUC warrants external validation.