TOT for treatment of stress urinary incontinence: how should we assess its equivalence with TVT?

• Published in: International Urogynecology Journal Vol. 21; no. 8; pp. 947 - 953
• Main Authors: EL-Hefnawy, Ahmed S., Wadie, Bassem S., El Mekresh, Mohsen, Nabeeh, Adel, Bazeed, Mahmoud A.
• Format: Journal Article
• Language: English
• Published: London Springer-Verlag 01.08.2010; Springer Nature B.V
• Subjects: Adult; Female; Gynecology; Humans; Kaplan-Meier Estimate; Medicine; Medicine & Public Health; Middle Aged; Original Article; Pain - epidemiology; Pain - etiology; Prevalence; Prospective Studies; Suburethral Slings - adverse effects; Treatment Outcome; Urinary Incontinence, Stress - surgery; Urology; Urinary incontinence; TOT; TVT; Mid-urethral slings; Randomized controlled trial; Clavien’s classification
• ISSN: 0937-3462; 1433-3023
• DOI: 10.1007/s00192-010-1138-9

Introduction and hypothesis Synthetic mid-urethral slings are currently considered the treatment of choice for stress urinary incontinence (SUI). In this study, two types of slings are compared: TVT vs. TOT. Methods In a prospective randomized study, 40 patients underwent either TVT (19 patients) or TOT (21 patients). Stress-specific and overall success was evaluated. Perioperative complications were classified according to Clavien’s classification. Results Mean duration of follow-up was 20 months. At last follow-up, stress-specific success rate was 94.6% in TVT vs. 81% in TOT. No significant difference was detected in terms of post-void residual urine, symptom score, and filling and voiding parameters. Thigh pain represented the main complication in the TOT group. Conclusions Both TVT and TOT are effective procedures for treatment of SUI. When compared to each other, TOT seems to be inferior to TVT in terms of efficacy, causing less serious complications.