Surgical therapeutic index of tension-free vaginal tape and transobturator tape for stress urinary incontinence.
OBJECTIVE
The aim of this study was to obtain the surgical therapeutic index (STI) of tension-free vaginal tape (TVT) and transobturator tape (TOT) and compare it with the previously obtained result of Burch colposuspension.


METHODS
The study population consisted of 121 patients who were diagnosed as having stress urinary incontinence, underwent TVT or TOT between January 1, 2000 and June 30, 2005 and were followed up for at least 1 year. Patients with detrusor overactivity, urinary tract infection, intrinsic sphincter deficiency and pelvic organ prolapse more than stage II according to the POP-Q system were excluded. The cure and complication rates were investigated, and the STI (median percent cure rate/median percent complication rate) of each operation was calculated.


RESULTS
Of the 121 patients, 61 underwent TVT and 60 received TOT. Patient characteristics and the results of preoperative urodynamic studies showed no significant difference between the two groups. The STI of TOT (2.72, 4.08, 4.23, 5.29) was higher than that of Burch colposuspension (1.19, 2.27, 2.89, 3.53) and TVT (2.77, 3.69, 3.23, 3.17) irrespective of follow-up months (at 1, 3, 6, 12 months).


CONCLUSIONS
TOT seems to be a more suitable surgical procedure for stress urinary incontinence with urethral hypermobility.
Jeon
Myung Jae
MJ
Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Korea.
Chung
Da Jung
da J
Park
Joo Hyun
JH
Kim
Sei Kwang
SK
Kim
Jae Wook
JW
Bai
Sang Wook
SW
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D053825:Suburethral Slings; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000379:methods*