[A prospective randomized trial of comparing the clinical outcome of tension-free vaginal tape and transobturator tape for stress urinary incontinence]

Abstract

Objective: To compare the morbidity and efficacy of tension-free vaginal tape (TVT) and transobturator tape (TVT-O) procedures in the treatment of stress urinary incontinence.

Methods: A total of 315 women were randomly assigned to undergo the procedure of either TVT (n = 160) or TVT-O (n = 155). Some patients underwent vaginal repair, hysterectomy, hysterosalpingo-oophorectomy, posterior intravaginal slingplasty or sacrospinous ligament fixation as concomitant procedures as indicated.

Results: Fifteen patients were lost to follow-up. And the median follow-up period was 27 months. The curing rates were 93.5%, 89.6%, 87.2% and 82.9% in the TVT group and 91.1%, 89.8%, 86.2% and 83.3% in the TVT-O group at 6, 12, 24 and 36 months respectively. No significant difference could be found for the curing rates between two groups at the same follow-up time and between 6-36 months follow-up in each group (P > 0.05). The median operative duration of the TVT-O group was significantly shorter than that of the TVT group [(18.7 ± 4.2) vs (24.3 ± 4.5) min] (P < 0.01). Compared with the TVT group, the TVT-O group had more patients complaining of groin and thigh pain (P < 0.05).

Conclusion: Both approaches appear to lower the peri- and post-operative complication rates and have an equal efficacy in the surgical treatment of stress urinary incontinence during a 3-year follow-up. However, TVT-O has a shorter operative duration with a higher rate of groin and thigh pain.