title: Modified prepubic TVT-obturator tape procedure versus the conventional method: a preliminary study.
abstract: OBJECTIVE
  To compare the efficacy and safety of the modified prepubic tension-free vaginal tape-obturator (PTVT-O) system procedure with the original TVT-O methods.
  
  
  METHODS
  One hundred and ninety women with urodynamic stress incontinence (USI) were included in this study (93 cases in the TVT-O group and 97 in the PTVT-O group). Clinical assessments before and one year after surgery included urinalyses, 1-h pad tests, urodynamic studies, and a personal interview with the overactive bladder symptom score (OABSS) questionnaire.
  
  
  RESULTS
  There were no differences between the two groups in mean age, parity, menopausal status, mean operative time and subjective cure rates (P>0.05), but the efficacy of surgery (cure and improvement) in the PTVT-O group was significantly higher than that in the TVT-O group (P=0.038). Complication rates and visual analog scale (VAS) scores were found to be similar (P>0.05). OABSS decreased significantly after surgery in both groups (P<0.05) although all urodynamic parameters revealed no significant difference after both procedures (P>0.05).
  
  
  CONCLUSIONS
  Our modified procedure is a safe and effective treatment for female USI. It has an advantage over the original TVT-O with better surgical efficacy and comparable postoperative pain, although the follow-up times in this study are different.
authors.affiliation: Graduate Institute of Medicine, Center of Excellence for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Obstetrics and Gynecology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Cheng-Yu
authors.initials: CY
authors.lastname: Long
authors.forename: Ming-Ping
authors.initials: MP
authors.lastname: Wu
authors.forename: Chiu-Lin
authors.initials: CL
authors.lastname: Wang
authors.forename: Kun-Ling
authors.initials: KL
authors.lastname: Lin
authors.forename: Cheng-Min
authors.initials: CM
authors.lastname: Liu
authors.forename: Shu-Hui
authors.initials: SH
authors.lastname: Wu
authors.forename: Yung-Shun
authors.initials: YS
authors.lastname: Juan
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D053825:Suburethral Slings; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000295:instrumentation / Q000379:methods*
keywords: Modified TVT-O; Overactive bladder; Stress urinary incontinence; Surgical efficacy; Visual analog scale