title: Comparison of TVT, TVT-O/TOT and mini slings for the treatment of female stress urinary incontinence: 30 months follow up in 531 patients.
abstract: BACKGROUND
  Although mid-urethral slings (MUS), have been extensively used for the treatment of female stress urinary incontinence (SUI), no published data exists for the efficiency and the complications of these methods in large patient series.
  
  
  METHODS
  This is a retrospective analysis on patients who underwent MUS surgery since 1999. 531 patients were studied and the results of preoperative assessment, perioperative, early postoperatively and each follow up were registered. Patients were classified in three groups according to the MUS used. Efficacy of each method was evaluated in terms of early postoperative course, late complications and patient's symptoms improvement based questioners, pad test, uroflowmetry, filling cystometry and ultrasonography. Evaluation took place at 7th and 30th postoperative day, 3rd and 12th month and then annually. Each patient was characterized as cured, improved or failed.
  
  
  RESULTS
  Trans Obturator (TO) group prevailed in efficiency with no significant differences between trans obturator route with inside-out (TVT-O) and outside-in (TOT). Success rate at 30th month evaluation, was higher in the TO group than in Tension-free Vaginal Tape (TVT) or Single-Incision Mini Slings (SIMS) group (93.4% vs 89.5%, 93.4% vs. 91.7%). None TVT patient required reoperation for remaining/reoccurring SUI, while 1.04% of TO group and 5.48% of SIMS group did. Patients of TVT group underwent reoperation for tape related complications in 2.25%, while 2.07% of TO group and none of SIMS group did. The potential limitation of the study is its retrospective character.
  
  
  CONCLUSIONS
  Even though TO tapes and SIMS seem more efficient than TVT, they carry a risk of SUI re-occurrence that must be weighted towards the risk of potential complications after TVT.
authors.affiliation: Department of Urology, Hippokrateio General Hospital of Thessaloniki, Greece.
authors.forename: Charalambous
authors.initials: C
authors.lastname: Stavros
authors.forename: Vouros
authors.initials: V
authors.lastname: Ioannis
authors.forename: Sakalis I
authors.initials: SI
authors.lastname: Vasileios
authors.forename: Anastasia Ch
authors.initials: ACh
authors.lastname: Gkotsi
authors.forename: Salpiggidis
authors.initials: S
authors.lastname: Georgios
authors.forename: Athanasios
authors.initials: A
authors.lastname: Papathanasiou
authors.forename: Vasileios
authors.initials: V
authors.lastname: Rombis
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D053825:Suburethral Slings; D013997:Time Factors; D014550:Urinary Incontinence, Stress / Q000601:surgery*