The comparison of treatment outcome of Transobturator tape and Tension-free vaginal tape obturator as the treatment of stress urinary incontinence

Lee, Eun Joo; Jeon, Myung Jae; Jung, Hyun Joo; Kim, Sei Kwang; Bai, Sang Wook

Abstract

OBJECTIVE
The aim of this study was to compare the treatment outcome of Transobturator tape (TOT) and Tension-free vaginal tape obturator (TVT-O) as the treatment of stress urinary incontinence (SUI).
METHODS
This prospective study included 332 women who were urodynamically diagnosed as stress urinary incontinence from April 2005 to January 2007. Patients showing pelvic organ prolapse higher than stage II by the Pelvic Organ Prolapse Quantification system or patients with detrusor overactivity were excluded from this study. The patients were alternatively selected to undergo TOT (n=192) or TVT-O (n=140) procedure and followed up at 1, 3, 6, 12 months postoperatively to compare the treatment outcome. Three hundred and six of them were available at 1 year follow up, 185 had the TOT operation, 121 the TVT-O procedure. The student t-test, chi square test were used for statistical analysis.
RESULTS
There were no statistically significant differences in general characteristics between two groups. No differences were found between 2 groups in the cure rates, postoperative complication such as voiding difficulty, De novo urgency, urinary tract infection, vaginal mesh erosion except groin pain. The groin pain rate of two groups showed significant difference. (TOT; 3.78% vs TVT-O; 9.92%, P=0.030).
CONCLUSIONS
This study indicates that the TOT and TVT-O procedures are safe and effective treatments for female stress urinary incontinence. However, TVT-O shows high incidence of groin pain rate and it may be related to nerve irritation by inflammation of surrounding tissue around the pudendal and obturator nerve, according to anatomical differences of the tape position in two procedures.