Transvaginal vs transobturator approach for synthetic sling placement in patients with stress urinary incontinence

• Published in: International Urogynecology Journal Vol. 19; no. 3; pp. 357 - 360
• Main Authors: Charalambous, S., Touloupidis, S., Fatles, G., Papatsoris, A.G., Kalaitzis, Ch, Giannakopoulos, S., Rombis, V.
• Format: Journal Article
• Language: English
• Published: London Springer-Verlag 01.03.2008; Springer Nature B.V
• Subjects: Female; Follow-Up Studies; Gynecology; Humans; Medicine; Medicine & Public Health; Middle Aged; Original Article; Polypropylenes; Postoperative Complications; Prosthesis Design; Prosthesis Implantation - instrumentation; Retrospective Studies; Suburethral Slings; Treatment Outcome; Urinary incontinence; Urinary Incontinence, Stress - physiopathology; Urinary Incontinence, Stress - surgery; Urodynamics - physiology; Urologic Surgical Procedures - methods; Urology; Transvaginal; Transobturator; Stress urinary incontinence; Sling
• ISSN: 0937-3462; 1433-3023
• DOI: 10.1007/s00192-007-0440-7

We present comparative short-term experience with the transvaginal (TVT) and the transobturator (TVT-O) approaches for the treatment of stress urinary incontinence (SUI). We studied 315 women with SUI, treated with a tension-free tape placement. The TVT approach was applied in 265 women, while 50 women were treated by the TVT-O approach. The mean operation time was 25 and 17 min in the TVT and TVT-O group, respectively ( p  < 0.001). In the TVT group, continence rates were 87% after 1 year, while in the TVT-O group, the continence rate was 94%. Postoperative pain was reported in 14.4 and 28% of the TVT and TVT-O patients, respectively ( p  = 0.02). Complications such as bladder perforation, retropubic hematoma, and urinary retention took place only in the TVT group. Urinary tract infections were recorded in 20 and 8% of the TVT and TVT-O patients, respectively ( p  = 0.04), while vaginal erosion took place in 1.5 and 2% and de novo urgency in 14 and 8%. Both approaches show high rates of cure at the first postoperative year, while complications are less with the TVT-O procedure.