TVT and TVT-O for surgical treatment of primary stress urinary incontinence: prospective randomized trial

Krofta, Ladislav; Feyereisl, Jaroslav; Otčenášek, M; Velebil, P; Kasikova, E.; Krčmář, Michal

doi:10.1007/s00192-009-1027-2

Cited by 43 publications

(29 citation statements)

References 27 publications

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“…Similar results have been demonstrated in other studies such as Krofta et al [22]. These data suggest an improvement in quality of life for all patients.…”

Section: Cure Ratesupporting

confidence: 91%

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Tension-Free Vaginal Tape Versus Transobturator Tape for Treatment of Female Stress Urinary Incontinence: A 2-Year Follow-Up Investigation

Abdelwahab¹,

Sherif²

2010

UIJ

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Qmax = maximum flow rate SUI = stress urinary incontinence TOT = transobturator tape TVT = tension-free vaginal tape VLPP = Valsalva leak point pressure ABSTRACT KEYWORDS: Stress urinary incontinence; Transobturator tape (TOT); Tensionfree vaginal tape (TVT) INTRODUCTION:The purpose of the study was to compare intraoperative, perioperative, and long-term (2-year) safety and efficacy of procedures using tension-free vaginal tape (TVT) versus transobturator tape (TOT) for the treatment of female stress urinary incontinence (SUI). METHODS:Participants were 120 female patients with SUI. They were randomly assigned to 2 equal groups, receiving either TVT or TOT. All patients were evaluated by history, physical examination, urine culture, pelviabdominal ultrasound, and urodynamics; they also completed the International Consultation of Incontinence Questionnaire-Short Form (ICIQ-SF). Patients were followed for 2 years. The groups were compared for operative outcomes, complications, maximum flow rates (Qmax) before surgery and at 3-month follow-up intervals, cure rates, and ICIQ-SF scores. RESULTS:Patients receiving TVT had significantly higher intraoperative blood loss (P < .001) and longer operative times (P < .001). There was no significant group difference in length of hospital stay. Qmax levels decreased after surgery, with no group differences at any follow-up evaluation. Minor complications occurred in < 10% of all patients, with no significant group differences. The success rate was 93.3 % (cure 83.3%; improved 10%) following use of TVT and 96.6% (cure 86.6%; improved 10%) following use of TOT; group differences were not significant. All patients with failed procedures had VLPP < 60 cmH 2 0 and grade III SUI. Mean preoperative ICIQ-SF scores, a quality of life measure, were significantly lowered for all patients following surgery with no significant group differences. CONCLUSIONS: Use of TVT and TOT in surgery result in similar outcomes, including cure rates. Based on the results of this 2-year study, both procedures have similar morbidity and should be considered safe and effective. UroToday International Journal ® UI J

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“…Similar results have been demonstrated in other studies such as Krofta et al [22]. These data suggest an improvement in quality of life for all patients.…”

Section: Cure Ratesupporting

confidence: 91%

“…Therefore, morbidity was essentially the same across groups. Krofta et al [22] reported bladder perforation with 0.7% and 0% of TVT and TOT procedures, respectively. Iatrogenic bladder perforation occurred in 2 patients (3.3%) receiving TVT.…”

Section: Complicationsmentioning

confidence: 99%

Tension-Free Vaginal Tape Versus Transobturator Tape for Treatment of Female Stress Urinary Incontinence: A 2-Year Follow-Up Investigation

Abdelwahab¹,

Sherif²

2010

UIJ

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“…6 The included studies utilized heterogeneous terms to define pain and pain location (eg, groin pain, thigh pain, wound discomfort, inner thigh discomfort, and groin pain during vaginal palpation). [7][8][9][10][11][12] The largest prospective randomized trial comparing retropubic and transobturator midurethral slings was the Trial of Mid-Urethral Slings. 2 Selfadministered postoperative pain diaries and pain assessments were collected at regular intervals for up to 2 years.…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8][9][10][11][12] Strengths of our study include the large, randomized, prospective, multicenter Trial of MidUrethral Slings database used for this secondary analysis and the use of standardized questionnaires and strictly defined anatomic areas that were described to participants using standardized terminology and body maps at frequent intervals to assess postsurgical pain. The inclusion of the use of any pain medication for pain resulting from the incontinence operation in the definition of absence of surgical pain allowed for a clinically relevant assessment of the resolution of pain.…”

Section: Discussionmentioning

confidence: 99%

Surgical Pain After Transobturator and Retropubic Midurethral Sling Placement

Thomas

Siff

Jelovsek

et al. 2017

Obstetrical &Amp; Gynecological Survey

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OBJECTIVE:To compare prevalence and severity of any surgical pain between transobturator and retropubic slings; secondary aims were to compare pain at anatomic locations, pain medication use, and pain resolution between transobturator and retropubic slings and to compare pain between types of transobturator slings.METHODS: This is a secondary analysis of the Trial of Mid-Urethral Slings, which compared retropubic and transobturator sling outcomes and included 597 participants from 2006 to 2008. Postoperative assessments included body maps, visual analog scales, Surgical Pain Scales, and medication inventories for 30 days, at 6 weeks, and 6, 12, and 24 months. Postoperative pain prevalence and severity were compared. Mixed models compared pain resolution and severity over time. Regression models compared pain prevalence and severity between types of transobturator slings. Eighty percent power was provided for the primary outcome pain prevalence and 95% power was provided for the primary outcome pain severity.RESULTS: Postoperative prevalence of any surgical pain, pain severity, and pain medication was not different between retropubic and transobturator slings. Retropubic sling was associated with greater prevalence of suprapubic pain at 2 weeks (proportion difference 10.6%; 95% confidence interval [CI] 4.6-16.4%; P,.001).Transobturator sling was associated with greater prevalence of groin pain at 2 weeks (proportion difference 12.0%; 95% CI 7.1-16.8%; P,.001). There was no difference in pain resolution (odds ratio [OR] 1.11, 95% CI 0.88-1.40; P5.38). Between types of transobturator slings, the odds of surgical pain were similar at 2 (OR 2.39, 95% CI 0.51-11.31; P5.27) and 6 weeks (OR 0.46, 95% CI 0.02-9.20; P5.61).CONCLUSION: Transobturator and retropubic slings are associated with low prevalence of any surgical pain. Transobturator sling was associated with greater prevalence of groin pain at 2 weeks, and retropubic sling was associated with greater prevalence of suprapubic pain at 2 weeks. Surgical pain resolved quickly in both groups.

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“…However, these were not pooled estimates as different studies have used differing criteria for measuring outcome. Analysis of four RCT shows that the objective failure rates for TVT range from 10 to 19% 12,16,19,21 . Although in a study by Porena et al .…”

Section: Tension Free Vaginal Tape (Tvt)mentioning

confidence: 99%