Tension‐free vaginal tape‐obturator for the treatment of stress urinary incontinence: a 12‐year prospective follow‐up

Abstract

Objective To evaluate the long‐term safety and effectiveness of inside–out transobturator tape (tension‐free vaginal tape‐obturator, TVT‐O) for the treatment of stress urinary incontinence (SUI). Patients and Methods Between August 2004 and August 2006, 87 consecutive patients with SUI who underwent TVT‐O were enrolled in this prospective cohort study. Patients with mixed UI, or pelvic organ prolapse requiring surgery, were excluded. Data relating to long‐term postoperative complications, subjective satisfaction rate (Patient Global Impression of Improvement), objective cure rate (stress test), quality of life (QoL), and sexual function, were collected during follow‐up. The Incontinence Impact Questionnaire (IIQ‐7) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ‐12) were used to assess QoL and sexual function, respectively. Statistical analyses were performed using paired‐sample t‐tests. Results At the 12‐year follow‐up, 73 patients (84%) were available for evaluation. Overall, the long‐term complication rate was 45.2%. De novo overactive bladder was observed in 12.3% of patients. None of the patients reported severe voiding dysfunction that required treatment by tape removal or catheterisation. However, 16 patients (16/73, 21.9%) had voiding changes compared with their preoperative status. Persistent groin pain was reported in 1.4% of the patients, and tape exposure occurred in 5.5%. The subjective satisfaction rate and objective cure rate were 80.8% and 82.2%, respectively. Compared with preoperative scores, the IIQ‐7 score decreased significantly (P < 0.05), whilst there was no significant difference in the PISQ‐12 score (P = 0.893). Conclusions This 12‐year follow‐up study showed that TVT‐O is a highly effective procedure for the treatment of SUI. The long‐term complication rate appears to be slightly high, which should raise concern.

Comparison of outcomes between single‐incision sling and transobturator sling for treating stress urinary incontinence: A 10‐year prospective study

“…In our study, with increasing age and menopause duration, no patients reported OAB at the 2‐year follow‐up in the TVT‐O group, 3(9.7%) reported OAB at the 6‐year follow‐up, and 6(19.4%) reported it at the 10‐year follow‐up compared with none at the 2‐year follow‐up in the TVT‐S group and 1(3.0%) at the 6‐ and 10‐year follow‐ups, without significant differences ( P = 0.35; P = 0.05). In another TVT‐O 10‐year follow‐up study, the onset of de novo OAB symptoms was reported by 23 of 160 patients (14%), while in a 12‐year follow‐up, in which 73 patients (84%) were available for evaluation, OAB was observed in 12.3% of patients …”

TVT‐O for treatment of pure urodynamic stress urinary incontinence: Efficacy and adverse effects at 13‐years follow‐up

“…In addition, many studies supported the use of TO‐MUS, showing that transobturator insertion gives equivalent patient‐reported and clinician‐reported cure rates at short‐ and medium‐term follow‐up, compared with retropubic insertion 6‐8 . The long‐lasting benefits of transobturator route needed to be addressed, although recent studies with over 10 years follow‐up, reported excellent results in term of efficacy and safety 9,10 . The aim of the present prospective, multicenter study is to report, for the first time in the available literature, objective and subjective outcomes of women implanted with tension‐free vaginal tape‐obturator (TVT‐O) for pure SUI, at 13‐years follow‐up, to assess the long‐term efficacy, and the safety of this procedure.…”

“…[6][7][8] The long-lasting benefits of transobturator route needed to be addressed, although recent studies with over 10 years follow-up, reported excellent results in term of efficacy and safety. 9,10 The aim of the present prospective, multicenter study is to report, for the first time in the available literature, objective and subjective outcomes of women implanted with tensionfree vaginal tape-obturator (TVT-O) for pure SUI, at 13-years follow-up, to assess the long-term efficacy, and the safety of this procedure. We carefully studied in particular the incidence over the time of sling exposure.…”

The practice of Burch Colposuspension versus Mid Urethral Slings for the treatment of Stress Urinary Incontinence in developing country

“…6 In 2001, Delorme introduced the TOT procedure with the aim to avoid bladder, bowel, and major vascular injuries, reported with other retro-pubic sling techniques. 7 Numerous studies have compared the efficacy of Burch colposuspension and MUS. A meta-analysis of colposuspension and MUS demonstrated significantly higher overall and objective cure rates with MUS but a higher risk of bladder perforation in retropubic slings as compared to TOT.…”

“… 6 In 2001, Delorme introduced the TOT procedure with the aim to avoid bladder, bowel, and major vascular injuries, reported with other retro-pubic sling techniques. 7 …”