Retropubic versus transobturator tension‐free vaginal tape (TVT vs TVT‐O): Five‐year results of the Austrian randomized trial

Abstract

Aims: To compare outcomes of the retropubic versus the transobturator tension-free vaginal tape (TVT vs TVT-O) at 5 years. Methods: A total of 569 women undergoing surgery for primary stress incontinence were randomized to receive a retropubic or a transobturator tensionfree vaginal tape (TVT or TVT-O). Follow-up at 5 years included clinical examination, urodynamic studies and quality of life. The primary outcome measure was continence defined as a negative cough stress test at a volume of 300 mL. Secondary outcomes included urodynamic parameters, complications and quality of life. ClinicalTrials.gov (NCT 0041454). Results: Three hundred and thirty-one patients (59%) were evaluated at 5 years (277 were seen, examined and completed questionnaires; 54 only completed questionnaires). No significant differences were seen in rates of a negative cough stress test (83% vs 76%, respectively), urodynamic parameters and complications. Quality-of-life improved significantly in both groups, without significant differences between the groups. Erosion rates were 5.2% and 4.5%, and reoperation rates were 4.1% and 3.2% respectively. Conclusions: At 5 years, subjective and objective results after TVT and TVT-O are stable and similar, without statistical significant differences between the procedures.Major long-term problems appear rare.

Influence of age, BMI and parity on the success rate of midurethral slings for stress urinary incontinence

“…Attempts we also made by inquiring new residential address from the national registration office, arranging at least three possible follow-up appointments as well as sending postal questionnaires to women who did not attend the clinical appointment. As previously described [ 14 ], 58% of our patients responded to questionnaires at 5 years, but only 50% were available to complete the clinical examination. Therefore, the reasons for missing data within this trial are that the patient were unreachable by telephone, mail or e-mail, patients withdrawal as well as patients not available to reach the hospital for the clinical examination.…”

“…The current study is a secondary analysis utilizing an established database from a previously reported prospective randomized controlled noninferiority study by the Austrian Urogynaecology Working Group [ 3 , 14 ]. The aim of this study was to compare objective and subjective outcomes of TVT versus TVT-O as primary treatment for female stress urinary incontinence (SUI).…”

“…The Austrian Urogynaecological Working Group conducted a randomized controlled trial (RCT) to compare objective and subjective outcomes of TVT with those of TVT-O [ 3 , 14 ]. The aim of this study was to perform a secondary analysis of these data, in order to assess if age, BMI and parity at the time of surgery may influence the short- and long-term outcomes of women primarily treated for SUI with midurethral tapes.…”

Psychometric properties and validation of two global impression questionnaires (PGI‐S, PGI‐I) for stress incontinence in a German‐speaking female population

“…The present study is the validation of the German translation of the PGI‐S and PGI‐I in patients participating in the Austrian TVT versus TVT‐O Trial (http://ClinicalTrials.gov NCT 00441454) . This study was conducted by the Austrian Urogynecology Working Group (AUB) at 25 units in Austria and Germany, with both regional hospitals and academic hospitals participating.…”

“…Secondary outcome parameters were QoL measures and complications. Three months and 5‐years results of the trial have been reported …”