Tension-free vaginal tape versus transobturator tape for treatment of stress urinary incontinence: A comparative randomized clinical trial study

Abstract

ObjectiveThe objective of this study is to evaluate short- and mid-term results of tension-free vaginal tape (TVT) and transobturator tape (TOT) for the treatment of female stress urinary incontinence (SUI) in Imam Reza Academic Hospital. MethodsA total of 100 women with SUI treated using TVT (n = 50) or TOT (n = 50) between March 2008 and October 2010 were included in this prospective randomized clinical trial study. Preoperative workups, including case history, clinical examination, cough test, urodynamic study with abdominal leak point pressure and postvoiding residue measurements, pad test, transvaginal scan, and evaluation with International Consultation on Incontinence Modular Questionnaire–Urinary Incontinence (ICIQ-UI) and International Consultation on Incontinence Modular Questionnaire–Quality of Life (ICIQ-QOL), were performed. During hospitalization, the type of anesthesia, operative time, hospital stay, and catheter indwelling time were recorded. Postoperatively, continence status and subjective patient satisfaction were evaluated using a cough test and in some patients by a pad test also; transvaginal scan and ICIQ-UI and ICIQ-QOL evaluations at 1, 3, 6, 12, and 18 months of follow-up were performed for all patients. ResultsThe mean age was 52.02 ± 7.37 years in the TVT group and 52.27 ± 7.34 years in the TOT group. The rate of complications was similar in both groups. The operative time was 14.50 ± 7.40 and 15.00 ± 7.48 minutes (p = 0.86), hospital stay time 1.56 ± 0.51 and 1.52 ± 0.47 days (p = 0.76), and catheter indwelling time 1.58 ± 0.41 and 1.55 ± 0.47 days (p = 0.651) in the TVT and TOT groups, respectively. At 1, 3, 6, 12, and 18 months after intervention, ICIQ-UI and ICIQ-QOL were completed for all the patients and no significant difference was found between them. ConclusionOur study results showed that TVT and TOT methods have similar efficacy and safety for SUI, although the catheter indwelling time was significantly longer in the TVT group.