Comparison of retropubic and outside-in transoburator sling systems for the cure of female genuine stress urinary incontinence

Abstract

Objectives: Retropubic tension-free slings are a well established procedure in the treatment of SUI. There were and still are relevant complications and side effects. The transobturator approach is said to be safer and equally effective. This paper compares our data of the first TVT- and TOT-procedures to share our experience.

Methods: In this study (from May 1998 to November 1999 for TVT and from February 2003 to September 2003 for TOT) only patients (n=220 in each group) with genuine SUI due to urethral hypermobility and/or intrinsic sphincter deficiency not showing signs of vaginal prolapse were evaluated. The results of pre- and postoperatively conducted examinations, quality-of-life assessments and urodynamic studies are reported.

Results: TOT is equally effective with less intraoperative and postoperative complications (including induction of urge). The procedure is faster and does not necessarily need intraoperative cystoscopy (even though cystoscopy adds to the procedure's safety)--it is thereby cheaper.

Conclusions: performed under the right indication the transobturator approach seems to be preferable when a low-tension midurethral sling procedure is the method of choice.