Comparison on effects and complications of tension-free vaginal tape and transobturator tape in the surgical management of female stress urinary incontinence / 대한산부인과학회지

ABSTRACT

OBJECTIVE: The purpose of this study was to compare the effectiveness and complications between TVT and TOT in the surgical management of female stress urinary incontinence. METHODS: From December, 2005 to July, 2006, 72 patients were performed anti-incontinence surgery at our hospital. Group of TVT surgery were 35 cases and group of TOT surgery were 37 cases. We reviewed medical records and analyzed these cases about age, parity, weight, height, severity of incontinence, operation time, operation outcome, duration of hospitalization and complications. RESULTS: There were no differences in patients' mean age, parity, weight, height, menopausal status and severity of incontinence. Mean operation time of TOT group (40.2+/-30 min) was shorter than TVT group (46.7+/-32.4 min), but there was no statistical difference. In case of excluded LAVH, mean operation time of TOT group (21.4+/-9.4 min) was significantly shorter than TVT group (27.0+/-7.7 min). There were no statistical differences on mean hemoglobin drop and mean hospital stay. The objective rates of cure (88.6% vs 86.5%), improvement (5.7% vs 8.1%), and failure (5.7% vs 5.4%) were similar for the TVT and TOT groups, respectively. The subjective rates of cure (80% vs 81.1%), improvement (14.3% vs 13.5%), and failure (5.7% vs 5.4%) were similar for the TVT and TOT groups, respectively. In case of bladder perforation, TVT group (2 cases) was higher than TOT group (0 case) but there was no statistical difference. In case of vaginal erosion, urinary tract infection, pelvic hematoma, de novo overactive bladder, there were no statistical differences. CONCLUSION: The TVT and TOT are both effective surgical treatment for stress urinary incontinence. Especially, TOT is safe and time saving procedure because it needs no cystoscopy.