This study compares medium-term outcomes of retropubic tension-free vaginal tape (TVT) and transobturator tape (TOT) for stress urinary incontinence (SUI), focusing on patient satisfaction and overactive bladder (OAB) symptoms.
This prospective, single-surgeon cohort study included women with SUI who underwent TVT or TOT at a single center (July 2021-October 2022). Follow-up was conducted at 26-41 months through chart review and patient interviews. Satisfaction was rated on a 0-100% global scale (≥75% = satisfied). Outcomes and complications followed International Continence Society criteria. Continuous variables were compared with the Mann-Whitney U-test and categorical variables with Fisher's exact test. Sensitivity analysis addressed the effects of loss to follow-up. Statistical significance was set at P < 0.05.
Fifty-three women (25 TVT, 28 TOT) completed follow-up. Satisfaction (≥75%) was reported by 88.0% of TVT and 89.3% of TOT patients (P ≈ 1.00). Sensitivity analyses assuming all lost patients were satisfied or unsatisfied did not alter statistical significance (P ≈ 1.00 and P = 0.54, respectively). Among women with pre-existing overactive bladder, improvement in symptoms occurred in 78.3% (18/23) of TVT and 61.1% (11/18) of TOT patients (P = 0.47). One bladder perforation occurred in the TVT group; other complications were infrequent and similar between groups.
Both TVT and TOT provided high satisfaction and improvement in OAB symptoms at 26-41 months, with low complication rates. These findings suggest that both procedures remain safe and effective in the medium term, reinforcing their established role in the surgical management of SUI.
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. 2026 Feb 04 [Epub ahead of print]
Erika Gandelsman, Jonatan Neuman, Réka Fábián-Kovács, Talia Friedman, Menahem Neuman, Benjamin Feiner
Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel., Faculty of Medicine, Semmelweis University, Budapest, Hungary., Department of Obstetrics and Gynecology; Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel., Urogynecology and Pelvic Floor Medicine, Medical School, Bar-Ilan and the Negev Universities, Haifa, Israel.