Transvaginal vs transobturator approach for synthetic sling placement in patients with stress urinary incontinence.
We present comparative short-term experience with the transvaginal (TVT) and the transobturator (TVT-O) approaches for the treatment of stress urinary incontinence (SUI). We studied 315 women with SUI, treated with a tension-free tape placement. The TVT approach was applied in 265 women, while 50 women were treated by the TVT-O approach. The mean operation time was 25 and 17 min in the TVT and TVT-O group, respectively (p<0.001). In the TVT group, continence rates were 87% after 1 year, while in the TVT-O group, the continence rate was 94%. Postoperative pain was reported in 14.4 and 28% of the TVT and TVT-O patients, respectively (p=0.02). Complications such as bladder perforation, retropubic hematoma, and urinary retention took place only in the TVT group. Urinary tract infections were recorded in 20 and 8% of the TVT and TVT-O patients, respectively (p=0.04), while vaginal erosion took place in 1.5 and 2% and de novo urgency in 14 and 8%. Both approaches show high rates of cure at the first postoperative year, while complications are less with the TVT-O procedure.
Charalambous
S
S
Department of Urology, Hippocratio General Hospital of Thessaloniki, Thessaloniki, Greece.
Touloupidis
S
S
Fatles
G
G
Papatsoris
A G
AG
Kalaitzis
Ch
Ch
Giannakopoulos
S
S
Rombis
V
V
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011126:Polypropylenes; D011183:Postoperative Complications; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000295:instrumentation*; D012189:Retrospective Studies; D053825:Suburethral Slings; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics / Q000502:physiology; D013520:Urologic Surgical Procedures / Q000379:methods*
D011126:Polypropylenes