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
Department of Urology, Faculty of Medicine, Benha University, Benha, Egypt
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
ABBREVIATIONS AND ACRONYMS: ICIQ-SF, International Consultation of Incontinence Questionnaire-Short Form; ISD, intrinsic sphincteric dysfunction; PVR, postvoid residual; Qmax, maximum flow rate; SUI, stress urinary incontinence; TOT, transobturator tape; TVT, tension-free vaginal tape; VLPP, Valsalva leak point pressure.