Moscow State University of Medicine and Dentistry, 127206, Vucheticha 21, Moscow, Russia.
To compare the incidence of complications associated with the use of retropubic tension-free vaginal tape (TVT) and transobturator tension-free vaginal tape (TVT-O) for the management of stress urinary incontinence (SUI).
In a cross-sectional study, 1081 patients were treated for SUI via mid-urethral slings, and the outcomes of those treated via TVT and those treated via TVT-O were compared. Patients who suffered from recurrent or mixed urinary incontinence were excluded.
Group 1 included patients treated via TVT (n=207) and group 2 included those treated with TVT-O (n=570). There was a higher incidence of bladder perforation (5.4% versus 0.6%; P=0.001) and hematoma formation (9.1% versus 1.5%; P=0.001) in group 1 than in group 2. Compared with group 1, there was higher incidence of vaginal wall perforation in group 2 (0.0% versus 3.8%, P=0.044). The rate of intraoperative complications was not related to patient age, body mass index, or parity. Of the patients who did not leak urine during a cough test 1month after surgery, 90.9% still had a negative cough test at the long-term follow-up.
TVT-O was superior to TVT with regard to the incidence of bladder perforation and hematoma formation, but it resulted in more vaginal wall injuries.
Pushkar DY, Godunov BN, Gvozdev M, Kasyan GR. Are you the author?
Reference: Int J Gynaecol Obstet. 2011 Feb 9. Epub ahead of print.