Comparison of Tension-free Vaginal Tape Versus Transobturator Tape in Women with Stress Urinary Incontinence
AbstractObjective: This study compared the Tension-free vaginal tape (TVT) and Transobturator tape (TOT) procedures for surgical treatment of stress urinary incontinence in women.Materials and methods: This prospective non randomized clinical trial was conducted in Vali-e-asr hospital from March 2001 to March 2005. A total of 71 patients with clinical and urodynamic diagnosis of Stress urinary incontinence (SUI) were enrolled in the study. Patients were divided into two groups and underwent TVT or TOT procedures. Mean operation time, cure rate, post operative urinary retention, bleeding and infection were compared between two groups. SPSS software was used for statistical analysis. Chi square and fisher exact test calculated the effects of the nominal variables. Mean difference of quantitative variables were compared by student's T- test. P ≤0.05 was considered statistically significant.Results: There was no significant difference in mean time of operation and peri-operative complications among groups. Urinary retention was 13.8% (n=5) in the TVT group versus 2.8% (n=1) in TOT group (NS). The rates of cure (91.6% vs 91.4%), improvement (5.6% vs 8.6%) and failure (2.8% vs 0) were similar for the TVT and TOT groups. The rate of hemorrhagic complications was 5.5% in TVT and 2.8% in TOT group (NS). Conclusion: TOT appears to be equally efficient to TVT for surgical treatment of stress urinary incontinence after 30 months follow-up.
Ulmsten U, Petros P. Intravaginal slingplasty (IVS): an ambulatory surgical procedure for treatment of female urinary incontinence. Scand J Urol Nephrol 1995; 29: 75-82.
Delorme E. Transobturator urethral suspension: mini- invasive procedure in the treatment of urinary stress incontinence in women. Prog Urol 2001; 11: 1306-1313.
De Tayrac R, Deffieux X, Droupy S,Chauveaud-lambling A ,Calvanese-Benamour L, Fernandez H. A prospective randomized trial comparing tension- free vaginal tape and Transobturator suburethral tape for surgical treatment of stress urinary incontinence. AM J Obstet Gynecol 2004 ; 192(2): 339.
Bump RC, Mattiasson A, Bo k, Brubake VL, Delancey JOL, Klarskov P, et al. the standardization of terminology of female Gynecol. AM J Obstet Gynecol 1996 ; 175(1): 10-17.
Blaivas JG, Jacobs BZ .Pubovaginal fascial sling for the treatment of complicated stress urinary incontinence. J Urol 1991;145(6):1214- 1218.
Meschia M, Pifarotti P, Bernasconi F,Guercio E,Maffiolini M,Magatti f, et al. Tension free vaginal tape: analysis of outcomes and complications in 404 stress incontinent women. Int Urogynecol J 2001; 12 suppl:s24-27.
Moran P, Ward K, Johnson D, smiri W, Hilton P, Bibby J. Tension free vaginal tape – for primary genuine stress incontinence: a two center follow up study. BJU Int 2000; 86: 39-42.
Ulmsten U, Flaconer C Johnson P,Jomaa M,Lanner L,Nilsson CG,Olson I. A multi center study of tension free vaginal tape (TVT) for surgical treatment of urinary stress incontinence. Int Urogynecol J Pelvic Floor Dysfunct 1998; 9(4): 210- 213.
Wang AC, Lo TS .Tension free vaginal tape. A minimally invasive solution to urinary stress incontinence in Women. J Repord Med 1998 ; 43(5): 429-434.
Vierhout ME severe hemorrhage complicating tension free vaginal tape (TVT): a case report. Int Urogynecol J Pelvic floor Dysfunct 2001, 12(2): 139- 140.
Zilbert A, Farrell SA .External iliac artery laceration during tension- free vaginal tape procedure. Int Urogynecol J Pelvic floor Dysfunct 2001, 12 (2): 141- 143.
Delorme E, Droupy S, de Tayrac R, Delmas V. transobturator tape (uratape): a new minimally-invasive procedure to treat female urinary incontinence. Eur Urol 2004 ; 45 (2): 203-207.
Abouassaly R, Steinberg JR,Lemieux M,Maroic C,Gilchrist LI,Bourque JL,et al. complications of tension-free vaginal tape surgery: a multi institutional review. BJU Int 2004 ; 94 (1): 100-113.
Domingo S, Alama P, Ruiz N, Perales A, Pellicer A. Diagnosis, management, and prognosis of vaginal erosion after TOT procedure using a non woven thermally bonded polypropylene mesh. J urol 2005 ; 173(5): 1627-1630.
Mellier G, Benayed B, Bretones S, Pasquier JC. Suburethral tape via the obturator route: is the TOT simplification of the TVT? Int urogynecol J pelvic floor Dysfunct 2004 ; 15 (4): 227-32.