TVT-O vs TVT: a randomized trial in patients with different degrees of urinary stress incontinence

Abstract

TVT-O and TVT were compared in patients stratified according the severity of Stress Urinary Incontinence (SUI). Those patients with intrinsic sphincter deficiencies, overactive bladders, associated prolapses, neurovegetative disorders and recurrent SUI or under rehabilitative/medical therapies were all excluded. There were 208 women included. Operating times were longer, and postoperative pain greater for TVT (p < 0.001). TVT produced longer hospitalizations in severe SUI patients (p < 0.001). After 1 year of follow-up, incontinence was cured in all mild SUI patients with both techniques, in all severe SUI patients when treated with TVT and in 66% of them when treated with TVT-O (p < 0.001). Vaginal perforations occurred during the TVT-O (p = 0.01), bladder perforations during TVT (p = NS), bladder obstructions in mild SUI patients after TVT (p < 0.001). The severity of SUI is an important parameter that influences results after TVT-O and TVT, and could be used to guide surgeons in selecting the most effective intervention.

A retrospective comparative series comparing monarc and sparc suburethral slings

“…In particular the TVT-O group, using the in-out approach, had a higher reported incidence of groin pain however with a lower incidence of bladder perforation, urgency & voiding difficulty [15][16][17][18][19]. The lack of groin pain in this current study, particularly relating to the Monarc group, may be due to the out-in approach with a more precise placement of the trochar in the medial obturator canal that avoids the lateral neurovascular vessels.…”

Long Term Follow up of the Solyx Single Incision Sling in the Treatment of Female Stress Urinary Incontinence (SUI)

“…Retropubic and transobturator slings have favourable results but require three incisions and blind passage of trocars. This blind needle passage had the potential risk of visceral and vascular damage [7][8][9][10][11][12]. The use of single incision slings is appealing because of its minimal invasiveness, even less than TVT or TOT slings, and potential for decreasing morbidity.…”

Early Experience with Transobturator Tape in Management of Female Stress Urinary Incontinence

“…In 1996, Ulmsten and Petros developed Tension free Vaginal Tape (TVT) which revolutionized the treatment of SUI. TVT has become one of the popular techniques for treating SUI with a success rate between 84-92% 6 . However due to the potential complications the question for the best method of treatment continues to exists.…”