title: Outcome and sexual function after transobturator tape procedure versus tension-free vaginal tape SECUR: a randomized controlled trial.
abstract: OBJECTIVE
  This study aims to compare efficacy, safety, and sexual function between inside-out transobturator tape (TVT-O) and tension-free vaginal tape SECUR (TVT-S) procedures for stress urinary incontinence (SUI) treatment.
  
  
  METHODS
  Ninety-four women without concomitant pelvic organ prolapse repairs were randomly allocated to undergo TVT-O or TVT-S procedure. Demographic data, intraoperative and postoperative complications, and surgical outcomes were analyzed. Patients completed the Chinese version of the Incontinence Impact Questionnaire Short Form and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire Short Form (PISQ-12) before surgical operation and on follow-up after surgical operation.
  
  
  RESULTS
  There were no significant differences in cure rates between the two groups at 12 and 24 months of follow-up. Hematomas occurred in two patients in the TVT-O group. Urinary retention and de novo urinary urgency were similar in both groups. Operative time was significantly shorter for patients in the TVT-S group (P < 0.05), and postoperative groin/thigh pain was higher (P < 0.05) in the TVT-O group. In both groups, Incontinence Impact Questionnaire Short Form scores improved significantly after surgical operation (P < 0.001). Compared with a mean (SD) score of 33.9 (4.5) postoperatively (12 mo), the total PISQ-12 score before surgical operation was 30.9 (6.5), representing a significant difference (P = 0.021) in the TVT-S group. There was no significant difference in PISQ-12 scores before and after the TVT-O procedure.
  
  
  CONCLUSIONS
  The two techniques seem to be equally effective for SUI treatment. However, TVT-O results in a higher rate of groin/thigh pain and longer operative time. TVT-S can improve quality of life and sexual function in women with SUI.
authors.affiliation: From the Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Tang
authors.forename: Lan
authors.initials: L
authors.lastname: Zhu
authors.forename: Shuo
authors.initials: S
authors.lastname: Liang
authors.forename: Jinghe
authors.initials: J
authors.lastname: Lang
mesh_terms: D000328:Adult; D005260:Female; D006406:Hematoma / Q000209:etiology; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000209:etiology; D008875:Middle Aged; D061646:Operative Time; D010149:Postoperative Pain / Q000209:etiology; D019529:Sexuality; D053825:Suburethral Slings / Q000009:adverse effects; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D016055:Urinary Retention / Q000209:etiology