INTRODUCTION: The purpose of the study was to compare intraoperative, perioperative, and long-term (2-year) safety and efficacy of procedures using tension-free vaginal tape (TVT) versus transobturator tape (TOT) for the treatment of female stress urinary incontinence (SUI).
METHODS: Participants were 120 female patients with SUI. They were randomly assigned to 2 equal groups, receiving either TVT or TOT. All patients were evaluated by history, physical examination, urine culture, pelviabdominal ultrasound, and urodynamics; they also completed the International Consultation of Incontinence Questionnaire-Short Form (ICIQ-SF). Patients were followed for 2 years. The groups were compared for operative outcomes, complications, maximum flow rates (Qmax) before surgery and at 3-month follow-up intervals, cure rates, and ICIQ-SF scores.
RESULTS: Patients receiving TVT had significantly higher intraoperative blood loss (P < .001) and longer operative times (P < .001). There was no significant group difference in length of hospital stay. Qmax levels decreased after surgery, with no group differences at any follow-up evaluation. Minor complications occurred in < 10% of all patients, with no significant group differences. The success rate was 93.3 % (cure 83.3%; improved 10%) following use of TVT and 96.6% (cure 86.6%; improved 10%) following use of TOT; group differences were not significant. All patients with failed procedures had VLPP < 60 cmH20 and grade III SUI. Mean preoperative ICIQ-SF scores, a quality of life measure, were significantly lowered for all patients following surgery with no significant group differences.
CONCLUSION: Use of TVT and TOT in surgery result in similar outcomes, including cure rates. Based on the results of this 2-year study, both procedures have similar morbidity and should be considered safe and effective.
Osama Abdelwahab, Hammouda Sherif
Submitted August 18, 2010 - Accepted for Publication September 24, 2010
KEYWORDS: Stress urinary incontinence; Transobturator tape (TOT); Tension-free vaginal tape (TVT).
CORRESPONDENCE: Osama Abdelwahab, MD, 1st Gameel Street, Makkah Tower, 11513, Benha, Egypt ().
CITATION: Urotoday Int J. 2010 Oct;3(5).
doi:10.3834/uij.1944-5784.2010.10.13