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Comparison of Effectiveness between Tension-Free Vaginal Tape (TVT) and Trans-Obturator Tape (TOT) in Patients with Stress Urinary Incontinence and Intrinsic Sphincter Deficiency.
PLoS One. 2016; 11(5):e0156306.Plos

Abstract

BACKGROUND

The aim of this study was to compare the two types of mid-urethral slings for stress urinary incontinence (SUI) with intrinsic sphincter deficiency (ISD).

METHODS

This retrospective study included patients who underwent tension-free vaginal tape (TVT) procedure or transobturator tape (TOT) procedure by a single surgeon for SUI with ISD, defined as Valsalva leak point pressure (VLPP) < 60 cmH2O in a urodynamic study. Cases of neurogenic bladder, previous SUI surgery, and concomitant cystocele repair were excluded. The primary outcome was treatment success at 12 months, defined by self-reported absence of symptoms, no leakage episodes recorded, and no retreatment.

RESULTS

Among the 157 women who were included in the final analysis, 105 patients received TVT and 52 patients received TOT. Age, underlying diseases, Stamey grade, cystocele grade, and presence of urge incontinence were not significantly different between the two groups. Urodynamic parameters including maximal urethral closing pressure, detrusor overactivity, VLPP, urethral hypermobility (Q-tip ≥ 30°), were also comparable between the two groups. Success rate was significantly higher in the TVT group than in the TOT group (95.2% vs. 82.7%, p = 0.009). On multivariate analysis, only TOT surgery (OR = 3.922, 95%CI = 1.223-12.582, p = 0.022) was a risk factor for failure following surgical treatment.

CONCLUSION

TVT is more effective than TOT in treatment of female SUI with ISD.

Authors+Show Affiliations

Department of Urology, Konkuk University School of Medicine, Konkuk University Medical Center, Seoul, Korea.Department of Urology, Konkuk University School of Medicine, Konkuk University Medical Center, Seoul, Korea.Department of Urology, Konkuk University School of Medicine, Konkuk University Medical Center, Seoul, Korea.Department of Urology, Konkuk University School of Medicine, Konkuk University Medical Center, Seoul, Korea.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

27228092

Citation

Kim, Hyeong Gon, et al. "Comparison of Effectiveness Between Tension-Free Vaginal Tape (TVT) and Trans-Obturator Tape (TOT) in Patients With Stress Urinary Incontinence and Intrinsic Sphincter Deficiency." PloS One, vol. 11, no. 5, 2016, pp. e0156306.
Kim HG, Park HK, Paick SH, et al. Comparison of Effectiveness between Tension-Free Vaginal Tape (TVT) and Trans-Obturator Tape (TOT) in Patients with Stress Urinary Incontinence and Intrinsic Sphincter Deficiency. PLoS One. 2016;11(5):e0156306.
Kim, H. G., Park, H. K., Paick, S. H., & Choi, W. S. (2016). Comparison of Effectiveness between Tension-Free Vaginal Tape (TVT) and Trans-Obturator Tape (TOT) in Patients with Stress Urinary Incontinence and Intrinsic Sphincter Deficiency. PloS One, 11(5), e0156306. https://doi.org/10.1371/journal.pone.0156306
Kim HG, et al. Comparison of Effectiveness Between Tension-Free Vaginal Tape (TVT) and Trans-Obturator Tape (TOT) in Patients With Stress Urinary Incontinence and Intrinsic Sphincter Deficiency. PLoS One. 2016;11(5):e0156306. PubMed PMID: 27228092.
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TY - JOUR T1 - Comparison of Effectiveness between Tension-Free Vaginal Tape (TVT) and Trans-Obturator Tape (TOT) in Patients with Stress Urinary Incontinence and Intrinsic Sphincter Deficiency. AU - Kim,Hyeong Gon, AU - Park,Hyoung Keun, AU - Paick,Sung Hyun, AU - Choi,Woo Suk, Y1 - 2016/05/26/ PY - 2016/01/31/received PY - 2016/05/12/accepted PY - 2016/5/27/entrez PY - 2016/5/27/pubmed PY - 2017/7/28/medline SP - e0156306 EP - e0156306 JF - PloS one JO - PLoS One VL - 11 IS - 5 N2 - BACKGROUND: The aim of this study was to compare the two types of mid-urethral slings for stress urinary incontinence (SUI) with intrinsic sphincter deficiency (ISD). METHODS: This retrospective study included patients who underwent tension-free vaginal tape (TVT) procedure or transobturator tape (TOT) procedure by a single surgeon for SUI with ISD, defined as Valsalva leak point pressure (VLPP) < 60 cmH2O in a urodynamic study. Cases of neurogenic bladder, previous SUI surgery, and concomitant cystocele repair were excluded. The primary outcome was treatment success at 12 months, defined by self-reported absence of symptoms, no leakage episodes recorded, and no retreatment. RESULTS: Among the 157 women who were included in the final analysis, 105 patients received TVT and 52 patients received TOT. Age, underlying diseases, Stamey grade, cystocele grade, and presence of urge incontinence were not significantly different between the two groups. Urodynamic parameters including maximal urethral closing pressure, detrusor overactivity, VLPP, urethral hypermobility (Q-tip ≥ 30°), were also comparable between the two groups. Success rate was significantly higher in the TVT group than in the TOT group (95.2% vs. 82.7%, p = 0.009). On multivariate analysis, only TOT surgery (OR = 3.922, 95%CI = 1.223-12.582, p = 0.022) was a risk factor for failure following surgical treatment. CONCLUSION: TVT is more effective than TOT in treatment of female SUI with ISD. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/27228092/Comparison_of_Effectiveness_between_Tension_Free_Vaginal_Tape__TVT__and_Trans_Obturator_Tape__TOT__in_Patients_with_Stress_Urinary_Incontinence_and_Intrinsic_Sphincter_Deficiency_ L2 - https://dx.plos.org/10.1371/journal.pone.0156306 DB - PRIME DP - Unbound Medicine ER -