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Original Research

Comparison of effectiveness and safety of TVT and TOT procedures in the treatment of female stress urinary incontinence


1 Bezm-i Alem Vakıf Gureba Eğitim ve Araştırma Hastanesi, Üroloji Bölümü, İstanbul, Türkiye

2 Haseki Eğitim ve Araştırma Hastanesi, Üroloji Bölümü, İstanbul, Türkiye

3 İstanbul Tıp Fakültesi, Kadın Doğum Anabilim Dalı, İstanbul, Türkiye


DOI :
New J Urol. 2014; 9 (3): 64-71

Abstract

Objective: To compare the success, compli-cations and effects on life quality of transobtu-rator tape (TOT) and tension free vaginal tape (TVT) procedures for female stress urinary in-continence.

Materials and Methods: Between April 2007 and July 2010, 162 patients who diagno-sed stress urinary incontinence were enrolled into study. All patients’ preoperative urologi-cal histories were taken, physical examination, stress test, Q tip test, urinary ultrasonography, incontinence and quality of life questionnairi-es [Incontinence impact questionnaire (IIQ-7) and Urinary distres inventory (UDI-6)] were performed. Transobturator route was used in 87 patients and retropubic procedures were perfor-med in 75 patients. Stress test, Q tip test, urinary ultrasonography, incontinence and quality of life questionnairies (IIQ-7 and UDI-6) were repea-ted at 12 months after surgery and were compa-red with preoperative parameters.

Results: All patients were operated under general and spinal anesthesia. There was no dif-ference between the two groups in demographic data. The mean operation time of TOT group (15.3±4.2 minutes) was significantly shorter than TVT group (24.3±8.6 minutes) (p<0.001). Intraoperatively, 3 vaginal injuries (3.4%) in TOT group, 5 bladder injuries (6.6%) in TVT group were occured. In early postoperative pe-riod, acute urinary retention was seen in 4 cases (4.6%) in TOT group and in 6 cases (8%) in TVT group and patients were re-catheterized. Three patients (3.4%) in TOT group and 4 patients (5.3%) in TVT group were complicated with de novo urge incontinence and all patients were treated with anti cholinergic drugs. In both groups, postoperative IIQ-7, UDI-6 and Q-Tip test values were statistically significant improved in comparison of preoperative parameters. In our study the success rates in TOT and TVT groups were  90% and 89%, respectively.

Conclusions: In the treatment of SUI, TVT and TOT procedu-res success rates were similar in the short-term and complication rate of TOT was less than TVT group.


Abstract

Objective: To compare the success, compli-cations and effects on life quality of transobtu-rator tape (TOT) and tension free vaginal tape (TVT) procedures for female stress urinary in-continence.

Materials and Methods: Between April 2007 and July 2010, 162 patients who diagno-sed stress urinary incontinence were enrolled into study. All patients’ preoperative urologi-cal histories were taken, physical examination, stress test, Q tip test, urinary ultrasonography, incontinence and quality of life questionnairi-es [Incontinence impact questionnaire (IIQ-7) and Urinary distres inventory (UDI-6)] were performed. Transobturator route was used in 87 patients and retropubic procedures were perfor-med in 75 patients. Stress test, Q tip test, urinary ultrasonography, incontinence and quality of life questionnairies (IIQ-7 and UDI-6) were repea-ted at 12 months after surgery and were compa-red with preoperative parameters.

Results: All patients were operated under general and spinal anesthesia. There was no dif-ference between the two groups in demographic data. The mean operation time of TOT group (15.3±4.2 minutes) was significantly shorter than TVT group (24.3±8.6 minutes) (p<0.001). Intraoperatively, 3 vaginal injuries (3.4%) in TOT group, 5 bladder injuries (6.6%) in TVT group were occured. In early postoperative pe-riod, acute urinary retention was seen in 4 cases (4.6%) in TOT group and in 6 cases (8%) in TVT group and patients were re-catheterized. Three patients (3.4%) in TOT group and 4 patients (5.3%) in TVT group were complicated with de novo urge incontinence and all patients were treated with anti cholinergic drugs. In both groups, postoperative IIQ-7, UDI-6 and Q-Tip test values were statistically significant improved in comparison of preoperative parameters. In our study the success rates in TOT and TVT groups were  90% and 89%, respectively.

Conclusions: In the treatment of SUI, TVT and TOT procedu-res success rates were similar in the short-term and complication rate of TOT was less than TVT group.

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