One-year follow-up of tension-free vaginal tape (TVT) and trans-obturator suburethral tape from inside to outside (TVT-O) for surgical treatment of female stress urinary incontinence: a prospective randomised trial.
OBJECTIVE
To compare tension-free vaginal tape (TVT) and trans-obturator suburethral tape from inside to outside (TVT-O) for surgical treatment of stress urinary incontinence (SUI) for complications (primary end point) and success rate (secondary end point).


METHODS
Seventy-two consecutive patients, with a mean age of 53.2 yr (range: 38-69 yr) and affected by SUI, were included in this randomised controlled trial. After preoperative assessment, patients were randomly allocated to the TVT or TVT-O procedure. Operative time, perioperative complications, and hospital stay were prospectively recorded. Cure of SUI was defined as no leakage of urine during the stress test at urodynamic testing at the 12-mo evaluation. The Wilcoxon signed rank sum test, Mann-Whitney U test, McNemar test, and Fisher exact test were used to verify statistical significance, set at p<0.05.


RESULTS
All patients were evaluable at the 12-mo follow-up. The characteristics of patients were well balanced between groups after randomisation. The mean operative time was significantly shorter in the TVT-O group. Perioperative complications were significantly more common after the retropubic approach (5% and 27% in TVT-O and TVT groups, respectively, p<0.04). The groups did not differ significantly in intraoperative blood loss, hospital stays, and time to return to normal activities. Sixty-five patients (90%) were successfully treated for SUI 12 mo after the operation (89% and 91% for TVT-O and TVT groups, respectively).


CONCLUSIONS
Both techniques appear to be equally effective in the surgical treatment of SUI. However, TVT-O had a shorter operative time and lower overall perioperative complication rate.
Zullo
Marzio Angelo
MA
Department of Obstetrics and Gynecology, University of Rome Campus Bio-medico, Via Longoni 83, 00155 Rome, Italy. m.zullo@unicampus.it
Plotti
Francesco
F
Calcagno
Marco
M
Marullo
Elettra
E
Palaia
Innocenza
I
Bellati
Filippo
F
Basile
Stefano
S
Muzii
Ludovico
L
Angioli
Roberto
R
Panici
Pierluigi Benedetti
PB
D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008875:Middle Aged; D011183:Postoperative Complications; D053825:Suburethral Slings; D014521:Urethra / Q000503:physiopathology; D014550:Urinary Incontinence, Stress / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000379:methods*