Transobturator vs single-incision suburethral mini-slings for treatment of female stress urinary incontinence: early postoperative pain and 3-year follow-up.
OBJECTIVE
To compare related pain and cure using the transobturator and single-incision suburethral mini-sling anti-incontinence operations.


METHODS
Open, prospective, nonrandomized 2-armed study comparing 2 surgical procedures for treatment of female stress urinary incontinence (Canadian Task Force classification II-1).


METHODS
A university and a private hospital.


METHODS
One hundred sixty-two women with stress urinary incontinence underwent either a tension-free vaginal tape-obturator (TVT-O) or a single-incision (TVT-SECUR) suburethral or mid-urethral tape operation.


RESULTS
Pain levels were estimated using a visual analog scale, and outcome using the Urinary Distress Inventory and the Incontinence Impact Questionnaire. Postoperative vaginal and thigh pain was transient, lasting for up to 2 weeks, and occurred significantly more frequently in the TVT-O group (32% vs 1% and 32% vs 0%, respectively). Dyspareunia was not self-limited, and occurred more frequently in the TVT-SECUR group (7.9% vs 0%). Cure rates were 86.9% in the TVT-O group and 90.9% in the TVT-SECUR group. Complication rates were similar in the 2 groups.


CONCLUSIONS
Both procedures were effective, with few adverse effects. In sexually inactive patients, the TVT-SECUR procedure may be preferable because thigh and vaginal pain is largely averted with this procedure. Sexually active patients might be better referred for the TVT-O procedure because it was not followed by dyspareunia in our series. Patient choice of surgical method rather than randomization weakened the strength of this study.
Department of Obstetrics and Gynecology, Western Galilee Hospital, Nahariya, Israel. mneuman@netvision.net.il
Menahem
M
Neuman
Vladimir
V
Sosnovski
Mohammad
M
Kais
Ella
E
Ophir
Jacob
J
Bornstein
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology*; D011184:Postoperative Period; D011446:Prospective Studies; D053825:Suburethral Slings / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014621:Vagina / Q000601:surgery