Comparison of transobturator tape (TOT) vs Burch method in treatment of stress urinary incontinence

Abstract

This study aim was to compare the efficacy of transobturator tape (TOT) as a new sling procedure, and Burch colposuspension as the gold standard surgical technique, in the treatment of stress urinary incontinence (SUI). This prospective randomised clinical trial was conducted on 62 women with SUI diagnosed with urodynamic test in Vali-e-Asr Hospital, Tehran, Iran. Patients were allocated into two surgery groups, randomly; TOT and Burch (31 patients in each group). After treatment, they were followed-up for long-term outcome. The average duration of follow-up was 22 and 28 months in the TOT and Burch group, respectively. Operation duration and hospital stay in the TOT group was significantly less than the Burch group (p=0.001). The rate of complete cure, improvement and failure in the TOT group was 90.3%, 9.7% and 0%, respectively, as well as 74.2%, 19.4% and 6.5% in the Burch group. In the TOT group, 90.3% of patients were very satisfied, 6.5% moderately satisfied and 3.2% were less satisfied; none of them were unsatisfied. It is concluded that the TOT procedure is a safe and effective option with less operation time and shorter in-hospital stay for SUI treatment.

The effects of stress incontinence surgery on sexual function and life quality of women

“…In our study, TOT was found more superior over Burch operation in providing SUI. Although there are some studies supporting the results of our study in the literature (21,22), a study showed that Burch colposuspension surgery is more successful than TOT operation (23).…”

Outcome Assessment of the Marshall Coughing Test during Cervix Reposition Maneuver in Women with Urinary Stress Incontinence with/without Genital Prolapse

“…In presence of positive MT with CRM, a clear explanation should be given to the patient for avoiding an unpleasant postoperative surprise. As a confirmation of these, our statement is the fact that this percent, which we found as positive MT during CRP, is similar to those reported by most authors as a failure rate after anti-stress surgery [10, 19]. The noted percentage of positive MT during CRM in patients with isolated USI gave an affirmation of our second hypothesis.…”

“…On the other hand, the different antistress procedures in patients with USI without GP also can result in postoperative failure, perhaps due to vertical pelvic organ position. Different authors report different failure rate, from more than 30% to less than 10% [10–12]. Nevertheless, the cure rate shows a decreasing trend over the time.…”

Burch colposuspension

“…38 The same review confirmed results from two older randomized controlled trials including assessment of both the retropubic and transobturator MUS placement. 47,48 In a nationwide cohort study, Foss Hansen and colleagues reported, that Burch colposuspension MUS had a similar risk of reoperation (6%). 49 Another study conducted by Holdø and colleagues showed a significantly lower cumulative rate of recurrence up to 12 years after retropubic MUS than after Burch colposuspension.…”