Int Neurourol J.  2013 Sep;17(3):145-151.

Effectiveness of Retropubic Tension-Free Vaginal Tape and Transobturator Inside-Out Tape Procedures in Women With Overactive Bladder and Stress Urinary Incontinence

Affiliations
  • 1Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea.
  • 2Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 3Department of Urology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
  • 4Department of Urology, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea.
  • 5Department of Urology, Yonsei University College of Medicine, Seoul, Korea.
  • 6Department of Urology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
  • 7Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ksleedr@skku.edu

Abstract

PURPOSE
We compared the effectiveness of the retropubic tension-free vaginal tape (TVT) and the transobturator inside-out tape (TVT-O) in treating symptoms of overactive bladder (OAB) in women with stress urinary incontinence (SUI).
METHODS
Women with urodynamic SUI and OAB (mean urgency episodes > or =1 and frequency > or =8/24 hours on a 3-day voiding diary) were assigned to the TVT or TVT-O group. Preoperative measures were based on a urodynamic study, 3-day voiding diary, the Bristol Female Lower Urinary Tract Symptoms questionnaire (BFLUTS(SF)), and the urgency perception scale (UPS). At 12 postoperative months, the 3-day voiding diary, symptoms questionnaire, patient satisfaction, and standing stress test were assessed. The primary endpoint was change in the number of urgency episodes/24 hours from baseline to 12 months.
RESULTS
In this group of 132 women, 42 received TVT and 90 received TVT-O. The mean urgency episodes/24 hours decreased from 6.3+/-5.5 to 1.6+/-3.2 in the TVT group and from 5.1+/-4.4 to 1.8+/-3.0 in the TVT-O group. The mean percent change was significantly greater after TVT than after TVT-O (73% vs. 60%, P=0.049). All subscales of BFLUTS(SF) and UPS were significantly improved using either method, with significantly greater improvement seen in the quality of life (QoL) domain after TVT (P=0.002). There were no significant differences in the cure and satisfaction rates between the two groups.
CONCLUSIONS
Intervention with the TVT or the TVT-O significantly improved symptoms of OAB in women with SUI and OAB. Urgency and QoL significantly improved after TVT compared with that after TVT-O.

Keyword

Overactive urinary bladder; Stress urinary incontinence

MeSH Terms

Exercise Test
Female
Humans
Lower Urinary Tract Symptoms
Patient Satisfaction
Quality of Life
Suburethral Slings
Urinary Bladder, Overactive
Urinary Incontinence
Urodynamics
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