TVT vs. TOT: a comparison in terms of continence results, complications and quality of life after a median follow-up of 48 months

Zugor, Vahudin; Labanaris, Apostolos P.; Rezaei-Jafari, Mohammad-Reza; Hammerer, Peter; Dembowski, Joachim; Witt, J.H.; Wucherpfennig, Wigand

doi:10.1007/s11255-010-9708-9

Cited by 17 publications

(7 citation statements)

References 26 publications

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“…We agree with Zugor et al [16] in that although we did not identify a significant difference regarding the results from one technique or the other, the transobturator method resulted in fewer complications and better tolerance than did the retropubic method. In general, as shown by Latthe [17] in a meta-analysis, the incidences of vaginal injuries, abrasions and pain, especially at the inguinal level, were somewhat greater using the transobturator method, while the incidences of bladder injuries and urinary dysfunctions or difficulties were greater using the retropubic method.…”

Section: Discussionsupporting

confidence: 88%

Complications from the Placement of a Tension-Free Suburethral Sling Using the Transobturator and Retropubic Methods for Treatment of Female Urinary Incontinence

Arrabal-Polo¹,

Palao-Yago²,

Zuluaga-Gomez³

et al. 2012

Urol Int

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Objective: The aim of our study was to retrospectively analyze surgical complications arising from the collocation of suburethral mesh in the lower urinary tract, using both the transobturator and retropubic methods. Patients and Methods: During the period between November 2002 and June 2011, we retrospectively studied 190 patients that were treated for stress urinary incontinence using a tension-free suburethral sling. 50 patients were treated using the retropubic route (SPARC®), and 140 patients were treated using a transobturator (MONARC®). Results: In total, 16.57% of the patients presented with intraoperative, immediate postoperative or later postoperative complications. We observed a higher rate of complications with patients who were operated on retropubically (26%) than with patients who were operated on using the transobturator method (12%). Conclusions: The rate of complications for our study was low, and was even lower in the case of transobturator tape. Thus, we usually used transobturator tape in the treatment of stress incontinence.

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Section: Discussionsupporting

confidence: 88%

Complications from the Placement of a Tension-Free Suburethral Sling Using the Transobturator and Retropubic Methods for Treatment of Female Urinary Incontinence

Arrabal-Polo¹,

Palao-Yago²,

Zuluaga-Gomez³

et al. 2012

Urol Int

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“…When the patients who improved were added, the rates increased to 90% following use of TVT and 90.6% following use of TOT. Finally, these results are in agreement with Zugor et al [27], who had a cure rate of 81% for patients who received TVT and 77.7 for patients who received TOT. They also found improvement in 9.7% and 3.3% of patients and failure in 6.7% and 6.7% of patients following TVT and TOT, respectively.…”

Section: Cure Ratesupporting

confidence: 92%

Tension-Free Vaginal Tape Versus Transobturator Tape for Treatment of Female Stress Urinary Incontinence: A 2-Year Follow-Up Investigation

Abdelwahab¹,

Sherif²

2010

UIJ

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Qmax = maximum flow rate SUI = stress urinary incontinence TOT = transobturator tape TVT = tension-free vaginal tape VLPP = Valsalva leak point pressure ABSTRACT KEYWORDS: Stress urinary incontinence; Transobturator tape (TOT); Tensionfree vaginal tape (TVT) INTRODUCTION:The purpose of the study was to compare intraoperative, perioperative, and long-term (2-year) safety and efficacy of procedures using tension-free vaginal tape (TVT) versus transobturator tape (TOT) for the treatment of female stress urinary incontinence (SUI). METHODS:Participants were 120 female patients with SUI. They were randomly assigned to 2 equal groups, receiving either TVT or TOT. All patients were evaluated by history, physical examination, urine culture, pelviabdominal ultrasound, and urodynamics; they also completed the International Consultation of Incontinence Questionnaire-Short Form (ICIQ-SF). Patients were followed for 2 years. The groups were compared for operative outcomes, complications, maximum flow rates (Qmax) before surgery and at 3-month follow-up intervals, cure rates, and ICIQ-SF scores. RESULTS:Patients receiving TVT had significantly higher intraoperative blood loss (P < .001) and longer operative times (P < .001). There was no significant group difference in length of hospital stay. Qmax levels decreased after surgery, with no group differences at any follow-up evaluation. Minor complications occurred in < 10% of all patients, with no significant group differences. The success rate was 93.3 % (cure 83.3%; improved 10%) following use of TVT and 96.6% (cure 86.6%; improved 10%) following use of TOT; group differences were not significant. All patients with failed procedures had VLPP < 60 cmH 2 0 and grade III SUI. Mean preoperative ICIQ-SF scores, a quality of life measure, were significantly lowered for all patients following surgery with no significant group differences. CONCLUSIONS: Use of TVT and TOT in surgery result in similar outcomes, including cure rates. Based on the results of this 2-year study, both procedures have similar morbidity and should be considered safe and effective. UroToday International Journal ® UI J

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“…A IUU 'de novo' foi observada em 4,4% das nossas doentes, estando esta percentagem de acordo com a literatura (1,5 a 6,7%). 23 Relativamente à erosão da fita, as taxas descritas, variam entre 0,3 a 23%. 24 No nosso estudo detectaram-se 2,8% de erosões da mucosa, tendo-se verificado uma maior taxa no grupo submetido à técnica inside-out (oito doentes) e apenas dois casos no grupo outside-in.…”

Section: Discussionunclassified

Técnicas Transobturadoras na Incontinência Urinária de Esforço Feminina

et al. 2014

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). Ambas as técnicas foram concebidas com o intuito de evitar a passagem no espaço retropúbico, reduzindo assim o número de complicações. Conclusão: As taxas de cura para as abordagens transobturadoras oscilam entre 80 e 95%. A taxa de cura aumenta quando o mecanismo responsável pela incontinência urinária de esforço é a hipermobilidade da uretra, contudo não é alterada quando são realizadas concomitantemente outras cirurgias vaginais. Palavras-chave: Incontinência Urinária de Esforço; Slings Suburetrais. ABSTRACTIntroduction: Stress urinary incontinence affects about 20-40% of women. Treatment with transobturator mid-urethral slings is consensually accepted nowadays. The goal of this study was to evaluate the success rate and most frequent complications of surgical treatment with transobturator mid-urethral slings in stress urinary incontinence. Material and Methods:This study evaluated 363 patients who underwent correction of stress urinary incontinence with a transobturator tape in Hospitais da Universidade de Coimbra between January 1st 2008 and July 1st 2010. Results:The mean age of patients was 56 . In 13.5% of women, the correction of stress urinary incontinence was associated with other vaginal surgery. The majority of these women (95.3%) had urethral hypermobility. Only 0.8% of women suffered of perioperative complications, 5.2% of immediate postoperative complications and 15.7% of late postoperative complications. The global success rate was 93.7%. The success rate in patients with fixed urethra was lower (77.8%) comparing with the results of those with urethral hypermobility, being successful in 94.5% (p = 0.02). The success rate was similar in patients with or without vaginal surgeries. Discussion: Treatment with transobturator mid-urethral slings has high success rates and it became the first treatment chosen to stress urinary incontinence, even if they were treated with the technique outside-in (TOT. Both techniques were conceived to avoid passing through the retropubic space, decreasing the complicate matters number. Conclusions: The cure rates for the transobturator surgical approach range between 80 and 95%. The cure rate increases when the mechanism responsible for the urinary incontinence is urethral hypermobility, although it is not modified when are performed other vaginal surgeries concomitantly.

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TVT vs. TOT: a comparison in terms of continence results, complications and quality of life after a median follow-up of 48 months

Abstract: Although there were no significant differences between the two types of procedures in terms of continence results and quality of life, the TOT procedure demonstrates significantly better results in terms of the rate of complications, making it, if indicated, our first choice.

Cited by 17 publications

References 26 publications

Complications from the Placement of a Tension-Free Suburethral Sling Using the Transobturator and Retropubic Methods for Treatment of Female Urinary Incontinence

Complications from the Placement of a Tension-Free Suburethral Sling Using the Transobturator and Retropubic Methods for Treatment of Female Urinary Incontinence

Tension-Free Vaginal Tape Versus Transobturator Tape for Treatment of Female Stress Urinary Incontinence: A 2-Year Follow-Up Investigation

Técnicas Transobturadoras na Incontinência Urinária de Esforço Feminina

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