The original versus a modified inside-out transobturator procedure: 1-year results of a prospective randomized trial

• Published in: International Urogynecology Journal Vol. 22; no. 2; pp. 145 - 156
• Main Authors: de Leval, Jean, Thomas, Alexandre, Waltregny, David
• Format: Journal Article Web Resource
• Language: English
• Published: London Springer-Verlag 01.02.2011; Springer Nature B.V; Springer Science & Business Media B.V
• Subjects: Adult; Aged; Aged, 80 and over; Belgium - epidemiology; Female; Gynecologic Surgical Procedures - adverse effects; Gynecologic Surgical Procedures - methods; Gynecology; Human health sciences; Humans; Medicine; Medicine & Public Health; Middle Aged; Médecine de la reproduction (Gynécologie, andrologie, obstétrique); Original Article; Pain, Postoperative - epidemiology; Pain, Postoperative - etiology; Prospective Studies; Reproductive medicine (gynecology, andrology, obstetrics); Sciences de la santé humaine; Stress urinary incontinence; Suburethral Slings; Treatment Outcome; TVT-O; Urinary Incontinence, Stress - surgery; Urologie & néphrologie; Urology; Urology & nephrology; Belgium; Female stress urinary incontinence; Pain; TVT-O; Tension-free vaginal tape transobturator; Sub-urethral slings
• ISSN: 0937-3462; 1433-3023; 1433-3023
• DOI: 10.1007/s00192-010-1264-4

Introduction and hypothesis The aim of this study is to compare a modified inside-out transobturator procedure with its original counterpart [inside-out transobturator (TVT-O)] for the treatment of female stress urinary incontinence (SUI). Methods A prospective, randomized trial in women suffering from SUI was used. The modified procedure consisted of a shorter tape whilst the scissors or guide no longer perforated the obturator membrane. The primary outcome was the resolution of subjective and objective SUI at 1 year. Secondary outcome measures included adverse events, quality of life measures, and groin pain. Results One hundred seventy-five patients were randomized. No intraoperative complications were recorded. The SUI cure rate was 91.7% versus 90.7% (original versus modified, respectively; p  = 0.824). Incidence and intensity of groin pain was higher in the original TVT-O group on day 0 and 1 ( p  < 0.05), requiring more analgesics ( p  = 0.015) but not thereafter. Conclusions At 1 year follow-up, the modified inside-out transobturator tape procedure was as efficient and safe as the original technique but associated with less immediate postoperative groin pain.