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.
CONCLUSIONS: 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. |
