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TVT and TVT-Obturator: comparison of two operative procedures.
Eur J Obstet Gynecol Reprod Biol. 2007 Mar; 131(1):89-92.EJ

Abstract

AIM

To compare two anti-incontinence operations: the tension-free vaginal tape (TVT) and the TVT-Obturator for the first two 75-patient groups.

METHODS

One surgeon operated on two patient groups with urodynamically proven urinary stress incontinence. The first 75-patient group in 1998 included the first TVT procedures performed according to Ulmsten [Ulmsten U, Henriksson L, Johnson P, Varhos G. An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J 1996;7:81-6]. Follow-up lasted for 5-6 years. The second 75-patient group in 2004 included the first TVT-Obturator operations performed according to [De Leval J. Novel surgical technique for the treatment of female stress urinary incontinence: transobturator vaginal tape inside-out. Eur. Urol. 2003;44:724-30]. Follow-up lasted for 6-13 months.

RESULTS

The two patient groups were similar from the demographic and therapeutic points of view. The TVT-Obturator procedure required neither bladder catheterization nor intra-operative diagnostic cystoscopy. TVT-related bladder penetration (8.0%), post-operative voiding difficulties (5.0%), intra-operative bleeding (4.0%), post-operative field infection (2.7%), and post-operative pelvic floor relaxation (1.3%) were not noted with the TVT-Obturator. The early therapeutic failure rates were 2.7% for the TVT and 1.3% for the TVT-Obturator, and neither bowel nor urethral injuries were recorded.

CONCLUSIONS

The surgeons' learning curves of these two minimally invasive surgical procedures for the treatment of female urinary stress incontinence are comparable. The safety and cost-effectiveness of the TVT are well-established. The TVT-Obturator, a novel mid-urethral sling, was designed to overcome some of the TVT-related operative complications. The TVT-Obturator patients seem to have less intra-operative and post-operative surgical complications than the TVT patients. However, long-term comparative data collection is required prior to drawing solid conclusions concerning the superiority of one of these two operative techniques.

Authors+Show Affiliations

Urogynecology, Department of Gynecology, Shaare Zedek Medical Center, Ben-Gurion University of the Negev, Jerusalem 91031, Israel; Urogynecology Service, American Medical Center, Rishon Le-Zion, Israel. Electronic address: neuman@szmc.org.il.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16621224

Citation

Neuman, Menahem. "TVT and TVT-Obturator: Comparison of Two Operative Procedures." European Journal of Obstetrics, Gynecology, and Reproductive Biology, vol. 131, no. 1, 2007, pp. 89-92.
Neuman M. TVT and TVT-Obturator: comparison of two operative procedures. Eur J Obstet Gynecol Reprod Biol. 2007;131(1):89-92.
Neuman, M. (2007). TVT and TVT-Obturator: comparison of two operative procedures. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 131(1), 89-92. https://doi.org/10.1016/j.ejogrb.2006.03.007
Neuman M. TVT and TVT-Obturator: Comparison of Two Operative Procedures. Eur J Obstet Gynecol Reprod Biol. 2007;131(1):89-92. PubMed PMID: 16621224.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - TVT and TVT-Obturator: comparison of two operative procedures. A1 - Neuman,Menahem, Y1 - 2006/04/18/ PY - 2005/08/06/received PY - 2006/03/14/revised PY - 2006/03/15/accepted PY - 2006/4/20/pubmed PY - 2007/5/18/medline PY - 2006/4/20/entrez SP - 89 EP - 92 JF - European journal of obstetrics, gynecology, and reproductive biology JO - Eur J Obstet Gynecol Reprod Biol VL - 131 IS - 1 N2 - AIM: To compare two anti-incontinence operations: the tension-free vaginal tape (TVT) and the TVT-Obturator for the first two 75-patient groups. METHODS: One surgeon operated on two patient groups with urodynamically proven urinary stress incontinence. The first 75-patient group in 1998 included the first TVT procedures performed according to Ulmsten [Ulmsten U, Henriksson L, Johnson P, Varhos G. An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J 1996;7:81-6]. Follow-up lasted for 5-6 years. The second 75-patient group in 2004 included the first TVT-Obturator operations performed according to [De Leval J. Novel surgical technique for the treatment of female stress urinary incontinence: transobturator vaginal tape inside-out. Eur. Urol. 2003;44:724-30]. Follow-up lasted for 6-13 months. RESULTS: The two patient groups were similar from the demographic and therapeutic points of view. The TVT-Obturator procedure required neither bladder catheterization nor intra-operative diagnostic cystoscopy. TVT-related bladder penetration (8.0%), post-operative voiding difficulties (5.0%), intra-operative bleeding (4.0%), post-operative field infection (2.7%), and post-operative pelvic floor relaxation (1.3%) were not noted with the TVT-Obturator. The early therapeutic failure rates were 2.7% for the TVT and 1.3% for the TVT-Obturator, and neither bowel nor urethral injuries were recorded. CONCLUSIONS: The surgeons' learning curves of these two minimally invasive surgical procedures for the treatment of female urinary stress incontinence are comparable. The safety and cost-effectiveness of the TVT are well-established. The TVT-Obturator, a novel mid-urethral sling, was designed to overcome some of the TVT-related operative complications. The TVT-Obturator patients seem to have less intra-operative and post-operative surgical complications than the TVT patients. However, long-term comparative data collection is required prior to drawing solid conclusions concerning the superiority of one of these two operative techniques. SN - 0301-2115 UR - https://www.unboundmedicine.com/medline/citation/16621224/TVT_and_TVT_Obturator:_comparison_of_two_operative_procedures_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0301-2115(06)00152-7 DB - PRIME DP - Unbound Medicine ER -