Outcome and complications of retropubic and transobturator midurethral slings translated into surgical therapeutic indices.
OBJECTIVE
We sought to determine and compare surgical therapeutic indices (STIs) of the retropubic tension-free vaginal tape (TVT) and 2 kinds of transobturator tape (TOT), Monarc (American Medical Systems, Minneapolis, MN), and tension-free vaginal tape obturator.


METHODS
This was a retrospective cohort study. Patients with predominant stress urinary incontinence who underwent retropubic (TVT, n = 257) or TOT (n = 180) procedures were included. STIs for both groups were calculated by dividing cure by complication rate at, respectively, 2 and 12 months.


RESULTS
Two months after surgery the STI was significantly higher after TOT whereas 12 months after surgery results of STIs were equal. The explanation is more durable cure rates and declining long-term side effects after TVT procedures.


CONCLUSIONS
Both surgical approaches seem to have their own benefits. Based on the STI, the balance between cure rate and complications is on the short term in favor of TOT but on the long term similar for TOT and retropubic TVT.
Houwert
R Marijn
RM
Department of Obstetrics and Gynecology, St. Elisabeth Hospital Tilburg, Amsterdam, The Netherlands. marijnhouwert@hotmail.com
Roovers
Jan Paul W R
JP
Venema
Pieter L
PL
Bruinse
Hein W
HW
Dijkgraaf
Marcel G W
MG
Vervest
Harry A M
HA
D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D008875:Middle Aged; D012189:Retrospective Studies; D053825:Suburethral Slings / Q000009:adverse effects*; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics