A retrospective study comparing tension-free vaginal tape and transobturator suburethral tape for surgical treatment of female stress urinary incontinence --- a preliminary report.

BACKGROUND The aim of this study was to assess the efficacy and complications of tension-free vaginal tape (TVT) versus tension-free transobturator vaginal tape (TVT-O) from inside to outside for the surgical treatment of stress urinary incontinence (SUI) in women. METHODS Retrospectively, 35 patients with SUI were recruited into this study; 18 patients were assigned to the TVT procedure and 17 patients to the TVT-O operation. Preoperative evaluation included subjective symptoms according to the SEAPI incontinence score (IC score), objective assessment by urodynamic study (including cystometry, electromyography, urethral pressure profile, uroflow), and bead chain voiding cystourethrogram. Patients with cystocele greater than grade II were excluded. The mean operative time, hospital stay, perioperative complications, and 1-year outcome including SEAPI IC score and late complications were compared. RESULTS Patient characteristics and preoperative IC score were similar in the 2 groups. Mean operative time was significantly shorter in the TVT-O group (31.9 +/- 10 minutes vs. 55 +/- 12 minutes; p < 0.001). No bladder injury occurred in the TVT-O group versus 5.0% (n = 1) in the TVT group (p > 0.05). The rate of postoperative temporary dysuria was 28% (n = 5) in the TVT group versus 24% (n = 4) in the TVT-O group. The cure rate for SUI was 88%, similar for the TVT and TVT-O groups. As for late complications, no vaginal erosion was noted in the TVT-O group, but 1 bladder erosion with stone formation was found in the TVT group. In terms of bladder outlet obstruction, none developed in the TVT-O group, but 1 patient developed persistent dysuria in the TVT group. CONCLUSION There appears to be equal efficacy between TVT and TVT-O for the surgical treatment of female SUI, but operative time was significantly shorter in the TVT-O group because intraoperative cystoscopic check-up is not required.