title: Sequential comparisons of postoperative urodynamic changes between retropubic and transobturator midurethral tape procedures.
abstract: OBJECTIVE
  To sequentially compare the postoperative urodynamic changes in patients with urodynamic stress incontinence (USI) who underwent tension-free vaginal tape (TVT) or transobturator tape (Monarc TOT) procedure.
  
  
  METHODS
  Between January 2001 and December 2005, 50 consecutive patients with USI who underwent TVT (n = 24) or TOT (n = 26) procedures were studied, and postoperative urodynamic changes were sequentially compared by one-way ANOVA test with Bonferroni's correction.
  
  
  RESULTS
  There were no significant between-group postoperative changes in urodynamic parameters of uroflowmetry, filling and voiding cystometry. However, the TVT group had a higher objective cure rate (100% vs. 69.2%, P = 0.004) by pad test, urethral closure pressure area [40.4 cm(2) H(2)O, 95% confidence interval (CI) = 22.3-58.5 cm(2) H(2)O vs. 3.9 cm(2) H(2)O, 95% CI = -10.9 to 18.7 cm(2) H(2)O, P = 0.036], and continence area (34.4 cm(2) H(2)O, 95% CI = 16.1-52.7 cm(2) H(2)O vs. -3.5 cm(2) H(2)O, 95% CI = -16.7 to 9.8 cm(2) H(2)O, P = 0.001) at 12 months than those of the TOT group.
  
  
  CONCLUSIONS
  This study demonstrated that tension-free vaginal tape and transobturator tape procedures had no significant difference of impact on bladder voiding and storage functions. However, this study demonstrated that TVT procedure resulted in a higher cure rate with a significantly increased urethral closure pressure area and continence area than did TOT procedure 12 months postoperatively. Thus, TVT procedure might be a better therapeutic choice to achieve continence than TOT.
authors.affiliation: Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Pan-Chiao, Taipei, Taiwan, Republic of China.
authors.forename: Sheng-Mou
authors.initials: SM
authors.lastname: Hsiao
authors.forename: Ting-Chen
authors.initials: TC
authors.lastname: Chang
authors.forename: Chi-Hau
authors.initials: CH
authors.lastname: Chen
authors.forename: Ho-Hsiung
authors.initials: HH
authors.lastname: Lin
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications; D053825:Suburethral Slings; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000379:methods*; D014621:Vagina / Q000601:surgery