TVT vs. TOT: a comparison in terms of continence results, complications and quality of life after a median follow-up of 48 months

Abstract

Aim: To compare the tension-free vaginal tape (TVT) and obturator tape (TOT) procedures in terms of continence results, complications and quality of life after a median follow-up of 48 months.

Patients and methods: Two hundred and eight female patients suffering from urodynamically proven urinary incontinence underwent TVT or TOT. The clinicopathologic parameters of the patients included age, body mass index, type of incontinence, onset of incontinence, previous pelvic surgery, parity, menopausal statement, perioperative and postoperative complications and outcome in terms of continence and quality of life.

Results: TVT was performed on 48.6% of patients and TOT on 51.4%. The median age was 63.4 and median follow-up period was 48 months. Prior to surgery, stress urinary incontinence (SUI) was diagnosed in 75.7% of patients and mixed incontinence (SUI and urge incontinence) with a predominant SUI in 24.3%. An objective cure rate in patients who underwent TOT was observed in 77.7% of cases and in those who underwent TVT in 81%. The quality of life improved in 80% of cases. There was no significant difference between the procedures in terms of continence results and quality of life. The rate of the complications was significantly higher with the TVT procedure when compared to that of the TOT procedure.

Conclusions: Although there were no significant differences between the two types of procedures in terms of continence results and quality of life, the TOT procedure demonstrates significantly better results in terms of the rate of complications, making it, if indicated, our first choice.