OJOG  Vol.4 No.3 , February 2014
Treatment success of transobturator tape compared with tension free vaginal tape for stress urinary incontinence at 24 months: A randomized controlled trial
Abstract: Objective: To compare the long term efficacy of transobturator Tape (TOT) with tension free vaginal tape (TVT) at 24 months postoperatively. Patients & Methods: 160 women with stress urinary incontinence (SUI) were randomly allocated to either TVT or TOT procedures and reviewed at 24 months after surgery. The primary outcomes were objective cure (a negative cough stress test, and a negative 1-hour pad test), and subjective cure (defined as “very much better” or “much better” improvement in the Patient Global Impression of Improvement scale). The secondary outcomes included incontinence related quality of life (using Urogenital Distress Inventory Questionnaire, and Incontinence Impact Questionnaire), and complications. Results: No statistical difference was reported in objective and subjective cure rates between both groups. Objective cure rate was 85.6% and 81.6% in the TOT and TVT groups respectively (P = 0.55). Subjective cure rate in the TOT and TVT groups were 87% and 83% respectively (P = 0.68). There were no significant differences in postoperative complications and incontinence related quality of life. However, the operating time was significantly shorter in the TOT group compared with the TVT group (22.6 ± 3.9, 27.1 ± 3; respectively, P < 0.001). Conclusion: TOT and TVT procedures were equally efficient and safe for treatment of SUI, with maintenance of high objective and subjective cure rates for 24 months. Longer follow-up is needed to confirm these results.
Cite this paper: Hassan, M. , El-Tohamy, O. and Kamel, M. (2014) Treatment success of transobturator tape compared with tension free vaginal tape for stress urinary incontinence at 24 months: A randomized controlled trial. Open Journal of Obstetrics and Gynecology, 4, 169-175. doi: 10.4236/ojog.2014.43028.

[1]   Abrams, P., Cardoze, L., Fall, M., Griffiths, D., Rosier, P., Ulmsten, U., et al. (2003) The standardization of terminology of lower urinary tract function: Report from the Standardization Subcommittee of the International Continence Society. Urology, 61, 37-49. 02243-4

[2]   Hota, L.S., Hanaway, K., Hacker, M.R., Disciullo, A., Elkadry, E., Dramitinos, P., et al. (2012) TVT-secur (hammock) versus TVT-obturator: A randomized trial of suburethral sling operative procedures. Female Pelvic Medicine and Reconstructive Surgery, 18, 41-45. 13e31823bdbcf

[3]   Schierlitz, L., Dwyer, P.L., Rosamilia, A., Murray, C., Thomas, E., De Souza, A., et al. (2012) Three-year follow-up of tension-free vaginal tape compared with transobturator tape in women with stress urinary incontinence and intrinsic sphincter deficiency. Obstetrics and Gynecology, 119, 321-327.

[4]   Parden, A.M., Gleason, J.L., Jauk, V., Garner, R., Ballard, A. and Richter, H.E. (2013) Incontinence outcomes in women undergoing primary and repeat midurethral sling procedures. Obstetrics and Gynecology, 121, 273-278.

[5]   Barber, M.D., Kleeman, S., Karram, M.M., Paraiso, M.F., Walters, M.D., Vasavada, S., et al. (2008) Transobturator tape compared with tension-free vaginal tape for the treatment of stress urinary incontinence: A randomized controlled trial. Obstetrics and Gynecology, 111, 611-621.

[6]   Han, J.Y., Choo, M.S., Lee, Y.S., Seo, J.T., Kim, J.H., Kim, Y.H., et al. (2013) Effectiveness of retropubic tension-free vaginal tape and transobturator inside-out tape procedures in women with overactive bladder and stress urinary incontinence. International Neurourology Journal, 17, 145-151.

[7]   Uebersax, J.S., Wyman, J.F., Shumaker, S.A., McClish, D.K. and Fantl, J.A. (1995) Short forms to assess life quality and symptom distress for urinary incontinence in women: The Incontinence Impact Questionnaire and the Urogenital Distress Inventory. Continence Program for Women Research Group. Neurourology and Urodynamics, 14, 131-139.

[8]   Ward, K.L., Hilton, P., UK and Ireland TVT Trial Group (2004) A prospective multicenter randomized trial of tension-free vaginal tape and colposuspension for primary urodynamic stress incontinence: Two-year follow-up. American Journal of Obstetrics & Gynecology, 190, 324-331.

[9]   Yalcin, I. and Bump, R.C. (2003) Validation of two global impression questionnaires for incontinence. American Journal of Obstetrics & Gynecology, 189, 98-101.

[10]   Ross, S., Robert, M., Swaby, C., Dederer, L., Lier, D., Tang, S., et al. (2009) Transobturator tape compared with tension-free vaginal tape for stress incontinence: A randomized controlled trial. Obstetrics and Gynecology, 114, 1287-1294.

[11]   Weber, A.M., Abrams, P., Brubaker, L., Cundiff, G., Davis, G., Dmochowski, R.R., et al. (2001) The standardization of terminology for researchers in female pelvic floor disorders. International Urogynecology Journal and Pelvic Floor Dysfunction, 12, 178-186. 00004033

[12]   Novara, G., Artibani, W., Barber, M.D., Chapple, C.R., Costantini, E., Ficarra, V., et al. (2010) Updated systematic review and metaanalysis of the comparative data on colposuspension, pubovaginal slings, and midurethral tapes in the surgical treatment of female stress urinary incontinence. European Urology, 58, 218-238.

[13]   Latthe, P.M., Singh, P., Foon, R. and Toozs-Hobson, P. (2010) Two routes of transobturator tape procedures in stress urinary incontinence: A meta-analysis with direct and indirect comparison of randomized trials. BJU International, 106, 68-76. 09051.x

[14]   Ogah, J., Cody, J.D. and Rogerson, L. (2011) Minimally invasive synthetic suburethral sling operations for stress urinary incontinence in women. Neurourology and Urodynamics, 30, 284-291.

[15]   Barboglio, P.G. and Gormley, E.A. (2013) Retropubic versus transobturator slings—Are the outcomes changing with time? Current Urology Reports, 14, 386-394.

[16]   Freeman, R., Holmes, D., Hillard, T., Smith, P., James, M., Sultan, A., et al. (2011) What patients think: Patientreported outcomes of retropubic versus trans-obturator mid-urethral slings for urodynamic stress incontinence: A multicentrerandomised controlled trial. International Urogynecology Journal, 22, 279-286.

[17]   Wadie, B.S. and El-Hefnawy, A.S. (2013) TVT versus TOT, 2-year prospective randomized study. World Journal of Urology, 31, 645-649.

[18]   Albo, M.E., Litman, H.J., Richter, H.E., Lemack, G.E., Sirlsm L.T., Chai, T.C., et al. (2012) Treatment success of retropubic and transobturator mid urethral slings at 24 months. Journal of Urology, 188, 2281-2287.

[19]   Sirls, L.T., Tennstedt, S., Lukacz, E., Rickey, L., Kraus, S.R., Markland, A.D., et al. (2012) Condition-specific quality of life 24 months after retropubic and transobturator sling surgery for stress urinary incontinence. Female Pelvic Medicine & Reconstructive Surgery, 18, 291-295.

[20]   Richter, H.E., Albo, M.E., Zyczynski, H.M., Kenton, K., Norton, P.A., Sirls, L.T., et al. (2010) Retropubic versus transobturatormidurethral slings for stress incontinence. New England Journal of Medicine, 362, 2066-2076.