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Clinical and ultrasonographic comparison of tension-free vaginal tape and transobturator tape procedure for the treatment of stress urinary incontinence.
J Minim Invasive Gynecol. 2008 Jul-Aug; 15(4):425-30.JM

Abstract

STUDY OBJECTIVE

The purpose of this study was to compare tension-free vaginal tape (TVT) and the TVT-obturator (TVTO) procedures.

DESIGN

Multicenter retrospective cohort study (Canadian Task Force classification II-2).

SETTING

Tertiary teaching hospitals.

PATIENTS

We reviewed 82 women with urodynamically proven stress incontinence undergoing either TVT (n = 53) or TVTO (n = 29) without concomitant surgery.

INTERVENTION

TVT and TVTO procedure.

MEASUREMENTS AND MAIN RESULTS

All subjects underwent urinalyses, 1-hour pad testing, perineal ultrasonography, and urodynamic studies, as well as validated questionnaires before and 1 year after surgery. Mean operative time was significantly shorter in the TVTO group (16.8 +/- 10.7 minutes vs 28.6 +/- 6.9min, p <.01; unpaired t-test). The subjective and objective cure rates were comparable for the TVT and TVTO groups (p = .085 vs .19, respectively; Fisher's exact test). At rest or during Valsalva, the middle of the TVTO tape localized more distally than that of TVT on ultrasound scanning (p <.01; unpaired t-test). A higher rate of urethral kinking during straining was noted in the TVT group compared with the TVTO group after surgery (87% vs 25%, p <.01; chi2 test). After TVT, maximum urethral closure pressure increased significantly (83.6 +/- 24.6 cm H2O vs 69.2 +/- 25.9 cm H2O, p <.05), but this was not the case in the TVTO group (67.8 +/- 15.0 cm H2O vs 63.2 +/- 12.3 cm H2O, p >.05; paired t test).

CONCLUSION

With comparable subjective and objective cure rates, TVTO has the advantages over TVT with shorter operative time. However, the TVTO tape is at a less acute angle and localizes to a more distal part of the urethra, resulting in a lower rate of urethral kinking and less urethral compression.

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Authors+Show Affiliations

Long CY
Graduate Institute of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Hsu CS
No affiliation info available
Liu CM
No affiliation info available
Lo TS
No affiliation info available
Wang CL
No affiliation info available
Tsai EM
No affiliation info available

MeSH

FemaleHumansMiddle AgedPostoperative ComplicationsProsthesis ImplantationRetrospective StudiesSuburethral SlingsUltrasonographyUrinary Bladder Neck ObstructionUrinary Incontinence, StressUrodynamics

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18588852

Citation

Long, Cheng-Yu, et al. "Clinical and Ultrasonographic Comparison of Tension-free Vaginal Tape and Transobturator Tape Procedure for the Treatment of Stress Urinary Incontinence." Journal of Minimally Invasive Gynecology, vol. 15, no. 4, 2008, pp. 425-30.
Long CY, Hsu CS, Liu CM, et al. Clinical and ultrasonographic comparison of tension-free vaginal tape and transobturator tape procedure for the treatment of stress urinary incontinence. J Minim Invasive Gynecol. 2008;15(4):425-30.
Long, C. Y., Hsu, C. S., Liu, C. M., Lo, T. S., Wang, C. L., & Tsai, E. M. (2008). Clinical and ultrasonographic comparison of tension-free vaginal tape and transobturator tape procedure for the treatment of stress urinary incontinence. Journal of Minimally Invasive Gynecology, 15(4), 425-30. https://doi.org/10.1016/j.jmig.2008.03.003
Long CY, et al. Clinical and Ultrasonographic Comparison of Tension-free Vaginal Tape and Transobturator Tape Procedure for the Treatment of Stress Urinary Incontinence. J Minim Invasive Gynecol. 2008 Jul-Aug;15(4):425-30. PubMed PMID: 18588852.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical and ultrasonographic comparison of tension-free vaginal tape and transobturator tape procedure for the treatment of stress urinary incontinence. AU - Long,Cheng-Yu, AU - Hsu,Chun-Shuo, AU - Liu,Cheng-Min, AU - Lo,Tsia-Shu, AU - Wang,Chiu-Lin, AU - Tsai,Eing-Mei, PY - 2007/12/09/received PY - 2008/03/02/revised PY - 2008/03/07/accepted PY - 2008/7/1/pubmed PY - 2008/11/19/medline PY - 2008/7/1/entrez SP - 425 EP - 30 JF - Journal of minimally invasive gynecology JO - J Minim Invasive Gynecol VL - 15 IS - 4 N2 - STUDY OBJECTIVE: The purpose of this study was to compare tension-free vaginal tape (TVT) and the TVT-obturator (TVTO) procedures. DESIGN: Multicenter retrospective cohort study (Canadian Task Force classification II-2). SETTING: Tertiary teaching hospitals. PATIENTS: We reviewed 82 women with urodynamically proven stress incontinence undergoing either TVT (n = 53) or TVTO (n = 29) without concomitant surgery. INTERVENTION: TVT and TVTO procedure. MEASUREMENTS AND MAIN RESULTS: All subjects underwent urinalyses, 1-hour pad testing, perineal ultrasonography, and urodynamic studies, as well as validated questionnaires before and 1 year after surgery. Mean operative time was significantly shorter in the TVTO group (16.8 +/- 10.7 minutes vs 28.6 +/- 6.9min, p <.01; unpaired t-test). The subjective and objective cure rates were comparable for the TVT and TVTO groups (p = .085 vs .19, respectively; Fisher's exact test). At rest or during Valsalva, the middle of the TVTO tape localized more distally than that of TVT on ultrasound scanning (p <.01; unpaired t-test). A higher rate of urethral kinking during straining was noted in the TVT group compared with the TVTO group after surgery (87% vs 25%, p <.01; chi2 test). After TVT, maximum urethral closure pressure increased significantly (83.6 +/- 24.6 cm H2O vs 69.2 +/- 25.9 cm H2O, p <.05), but this was not the case in the TVTO group (67.8 +/- 15.0 cm H2O vs 63.2 +/- 12.3 cm H2O, p >.05; paired t test). CONCLUSION: With comparable subjective and objective cure rates, TVTO has the advantages over TVT with shorter operative time. However, the TVTO tape is at a less acute angle and localizes to a more distal part of the urethra, resulting in a lower rate of urethral kinking and less urethral compression. SN - 1553-4650 UR - https://www.unboundmedicine.com/medline/citation/18588852/Clinical_and_ultrasonographic_comparison_of_tension_free_vaginal_tape_and_transobturator_tape_procedure_for_the_treatment_of_stress_urinary_incontinence_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1553-4650(08)00116-7 DB - PRIME DP - Unbound Medicine ER -