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Comparison of tension-free vaginal tape and transobturator tape procedure for the treatment of stress urinary incontinence.
Curr Opin Obstet Gynecol. 2009 Aug; 21(4):342-7.CO

Abstract

PURPOSE OF REVIEW

The aim of this review was to assess the recent evidence on the effectiveness and complications of tension-free vaginal tape (TVT) and transobturator tape (TOT) procedures for female stress urinary incontinence between January 2008 and March 2009.

RECENT FINDINGS

A meta-analysis of recent studies revealed that the short-term objective cure rate was borderline worse in the TOT group compared with TVT [odds ratio (OR) 0.62; 95% confidence interval (CI) 0.37-1.00; P = 0.05]. Bladder perforation (OR 12.23; 95% CI 2.86-52.34) was significantly more common, whereas groin/thigh pain was significantly less in the TVT group (OR 0.32; 95% CI 0.11-0.92; P = 0.022). Postoperative urinary retention was slightly more in women undergoing TVT than those undergoing TOT (OR 1.6; 95% CI 0.90-3.12; P = 0.06). The rates of vaginal erosion (OR 0.34; 95% CI 0.09-1.33), de-novo urgency (OR 1.21; 95% CI 0.52-2.79) and urinary tract infection (OR 0.88; 95% CI 0.56-1.38) were comparable in both procedures. In addition, TVT appeared to be more obstructive than TOT, as evidenced by ultrasonographic and urodynamic findings. Changes in sexual function need further investigation because this issue has not been well studied for either sling procedure.

SUMMARY

TOT has the advantages over TVT with shorter operative time and a relatively lower complication rate. For women with intrinsic sphincter deficiency, however, TVT appears to be a better option because it is more obstructive.

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Authors+Show Affiliations

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

MeSH

FemaleGynecologic Surgical ProceduresHumansPostoperative ComplicationsSuburethral SlingsSurgical MeshTreatment OutcomeUrinary Incontinence, StressUrologic Surgical Procedures

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

19528799

Citation

Long, Cheng-Yu, et al. "Comparison of Tension-free Vaginal Tape and Transobturator Tape Procedure for the Treatment of Stress Urinary Incontinence." Current Opinion in Obstetrics & Gynecology, vol. 21, no. 4, 2009, pp. 342-7.
Long CY, Hsu CS, Wu MP, et al. Comparison of tension-free vaginal tape and transobturator tape procedure for the treatment of stress urinary incontinence. Curr Opin Obstet Gynecol. 2009;21(4):342-7.
Long, C. Y., Hsu, C. S., Wu, M. P., Liu, C. M., Wang, T. N., & Tsai, E. M. (2009). Comparison of tension-free vaginal tape and transobturator tape procedure for the treatment of stress urinary incontinence. Current Opinion in Obstetrics & Gynecology, 21(4), 342-7. https://doi.org/10.1097/GCO.0b013e32832e07bf
Long CY, et al. Comparison of Tension-free Vaginal Tape and Transobturator Tape Procedure for the Treatment of Stress Urinary Incontinence. Curr Opin Obstet Gynecol. 2009;21(4):342-7. PubMed PMID: 19528799.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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 - Wu,Ming-Ping, AU - Liu,Cheng-Min, AU - Wang,Tsu-Nai, AU - Tsai,Eing-Mei, PY - 2009/6/17/entrez PY - 2009/6/17/pubmed PY - 2009/9/30/medline SP - 342 EP - 7 JF - Current opinion in obstetrics & gynecology JO - Curr Opin Obstet Gynecol VL - 21 IS - 4 N2 - PURPOSE OF REVIEW: The aim of this review was to assess the recent evidence on the effectiveness and complications of tension-free vaginal tape (TVT) and transobturator tape (TOT) procedures for female stress urinary incontinence between January 2008 and March 2009. RECENT FINDINGS: A meta-analysis of recent studies revealed that the short-term objective cure rate was borderline worse in the TOT group compared with TVT [odds ratio (OR) 0.62; 95% confidence interval (CI) 0.37-1.00; P = 0.05]. Bladder perforation (OR 12.23; 95% CI 2.86-52.34) was significantly more common, whereas groin/thigh pain was significantly less in the TVT group (OR 0.32; 95% CI 0.11-0.92; P = 0.022). Postoperative urinary retention was slightly more in women undergoing TVT than those undergoing TOT (OR 1.6; 95% CI 0.90-3.12; P = 0.06). The rates of vaginal erosion (OR 0.34; 95% CI 0.09-1.33), de-novo urgency (OR 1.21; 95% CI 0.52-2.79) and urinary tract infection (OR 0.88; 95% CI 0.56-1.38) were comparable in both procedures. In addition, TVT appeared to be more obstructive than TOT, as evidenced by ultrasonographic and urodynamic findings. Changes in sexual function need further investigation because this issue has not been well studied for either sling procedure. SUMMARY: TOT has the advantages over TVT with shorter operative time and a relatively lower complication rate. For women with intrinsic sphincter deficiency, however, TVT appears to be a better option because it is more obstructive. SN - 1473-656X UR - https://www.unboundmedicine.com/medline/citation/19528799/Comparison_of_tension_free_vaginal_tape_and_transobturator_tape_procedure_for_the_treatment_of_stress_urinary_incontinence_ L2 - https://doi.org/10.1097/GCO.0b013e32832e07bf DB - PRIME DP - Unbound Medicine ER -
Grapherence [↓29]

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