Hip Biomechanical and Functional Changes Following Transobturator Tape Surgery for Stress Urinary Incontinence

Transobturator tape (TOT) is a widely used midurethral sling technique for treating stress urinary incontinence. Although groin and thigh pain have been reported, limited data exist regarding the effects of TOT on hip joint function and lower limb biomechanics. This study was aimed at evaluating short-term changes in hip range of motion (ROM), muscle strength, gait, and quality of life following TOT.

In this prospective cohort study, 33 women undergoing TOT were assessed preoperatively and at 12 weeks postoperatively. Evaluations included bilateral hip ROM using a goniometer, manual muscle strength testing via the Medical Research Council scale, and functional mobility tests (Timed Up and Go, 10-Meter Walk Test). Patient-reported outcome measures included Urogenital Distress Inventory (UDI-6), Incontinence Impact Questionnaire (IIQ-7), Short Form (SF-12), and the Forgotten Joint Score (FJS). Leg length was measured from the anterior superior iliac spine to the medial malleolus. Paired t tests were used for pre- and postoperative comparisons.

Significant reductions were observed in hip ROM, particularly in internal and external rotation (p < 0.01). Hip adduction strength decreased modestly but significantly (p < 0.01). Apparent leg length increased slightly, although the change was not clinically meaningful. Despite these biomechanical changes, no significant differences were found in gait performance, SF-12 scores, or FJS. Urinary symptoms improved significantly, with marked reductions in UDI-6 and IIQ-7 scores (p < 0.001).

Transobturator tape surgery is associated with measurable but subclinical biomechanical changes. These did not impair functional mobility or joint perception. Further research is needed to explore long-term musculoskeletal effects and the potential benefits of perioperative physiotherapy.