The transvaginal tape surgery vs. trans-obturator tape for stress urinary incontinence

Abstract

: Female urinary incontinence is a highly prevalent condition affecting women’s quality of life and is associated with considerable personal and societal stress. Stress urinary incontinence (SUI) is thought to be due to the loss of urethral support vs. a weakness of the urethra itself. Multiple treatment options exist for the SUI including conservative behavioral modifications, physical therapy, medications, and surgical options. Surgical options can be offered to patients who achieve unsatisfactory results from non-surgical options or who prefer to have surgery by choice. Numerous surgical options for SUI have been described and have evolved over time. This evolution of surgery for SUI has led to more minimally invasive surgical options. The gains in the knowledge of anatomy of the bladder and urethra has also shifted the focus of continence mechanism to be at the mid urethra and not just the bladder neck as previously thought. This has led the mid urethral sling (MUS) to be the surgical options of choice by most surgeons. Patient selection and knowledge of the anatomy associated with midurethral slings are critical as the outcomes and complications associated with surgery are the results of these factors. The retropubic [transvaginal tape (TVT)] and the transobturator [trans-obturator tape (TOT)] MUSs are the main surgical options for SUI. Between the TVT and TOT sling, there is no one sling better or worse than the other.