Comparison of transobturator vaginal tape and retropubic tension-free vaginal tape: clinical outcome and sonographic results of a case-control study.
OBJECTIVE
To compare the results and ultrasonographic characteristics of the transobturator vaginal tape (TVT-O) and retropubic (TVT) methods.


METHODS
120 patients were treated with TVT-O. These were paired with similar patients treated with TVT. The patients were matched according to age, low-pressure urethra, preexisting mixed incontinence, and additional prolapse repair. The follow-up time was 3 months. Assessment variables included a standardized questionnaire, medical history, voiding diary, urinary stress test, 24-hour pad test, and introital ultrasound. The position of the tape was defined by its location in relation to urethral length (%) and the narrowness by its distance to the hypoechoic center of the urethra (mm).


RESULTS
The rates of postoperative complications including bladder perforation, urinary retention, and erosion through the vagina were similar. The number of hematomas occurring after TVT was insignificantly higher than after TVT-O (5 cases vs. 1 case). The rates for cure or improvement of stress incontinence were 77 and 17% after TVT-O and 85 and 14% after TVT (not significant). The sonographic characteristics were identical.


CONCLUSIONS
In terms of clinical outcome, TVT and TVT-O appear to be equally effective. Complications and sonographic characteristics of the tapes were similar after both procedures.
Reich
Andreas
A
Department of Obstetrics and Gynecology, University of Ulm, DE-89075 Ulm, Germany. andreas.reich@uniklinik-ulm.de
Wiesner
Kathrin
K
Kohorst
Frauke
F
Kreienberg
Rolf
R
Flock
Felix
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D053825:Suburethral Slings; D013514:Surgical Procedures, Operative / Q000379:methods; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014521:Urethra / Q000033:anatomy & histology / Q000601:surgery*; D014549:Urinary Incontinence / Q000503:physiopathology / Q000601:surgery; D053202:Urinary Incontinence, Urge / Q000503:physiopathology / Q000601:surgery; D014621:Vagina / Q000601:surgery