A modified inexpensive transobturator vaginal tape inside-out procedure versus tension-free vaginal tape for the treatment of SUI: a prospective comparative study

Abstract

Purpose: To prospectively compare, in terms of efficacy and safety, the tension-free vaginal tape (TVT) and our modified transobturator vaginal tape inside-out (TVT-O) procedure with self-tailored monofilament macroporous polypropylene mesh for stress urinary incontinence (SUI).

Methods: A total of 150 women with SUI were assigned to modified TVT-O (n = 95) and TVT (n = 55), respectively, the surgical outcomes compared 1 year later. A cough stress test was applied to the objective outcomes, while urinary incontinence specific quality of life (IQoL) questionnaire, to the subjective outcomes.

Results: The objective success rates defined as a negative stress test were found to be 95% in the TVT group and 96% in the modified TVT-O group, respectively. No significant difference was found between these two groups in the cure, improvement and failure rates (all P > 0.05), with significant improvement in quality of life (QoL) and no significant difference in patient satisfaction rates in two groups. In the TVT group were found three cases of bladder injuries. In the modified TVT-O group, operative duration, blood loss and medical cost were significantly reduced compared with those in the TVT one (P < 0.01).

Conclusions: In the study, the modified TVT-O procedure could be defined to be quicker, more economic with fewer bladder complications than the TVT approach while both were found to be manually simple and clinically mini-invasive with similar efficacy.