Comparative study of surgical care of stress incontinence using tension-free vaginale tape and transobturator tape

Introduction Tension free vaginale tape (TVT) and transobturator tape techniques (TOT) are frequently used for the treatment of stress incontinence. Objectives The purpose of this study is a comparative evaluation of the eficacy and postoperative complications of the two methods used for the treatment of stress incontinence. The study is also trying to establish the superiority of one method regarding both indications and postoperative results. Method This was a unicentric rethrospective study wich included all the patients admited in the Obstertrics and Gynecology section of Mulhouse Hospital (France), who underwent surgery using TVT and TOT technique, in a period of 10 years. From the patients admited in the study 76 were treated by using TVT technique and 176 by TOT technique. The postoperative follow up was between 7 and 12 months. Discutions The average age of two groups was not significantly different (58.4 years TVT and 57.09 years TOT). Most of the patients who underwent surgery presented with stress incontinence, 28.9% of TVT group presented with mixed incontinence compared with 17% of the TOT group and a very small number of patients belonging to both groups presented with urge incontinency. Postoperative, 76.6% of the TOT group patients were found to have post- void residual urine, greater than 58.2% in the TVT group. 18.2% of TVT patients developed imediate postoperative complications, almost twofold compared to 8.5% in the TOT group. This was shown by all comparative studies performed until now. 31.6% from TVT group presented with late postoperative complications compared with only 18.8% from the TOT group. Conclusions Both TOT and TVT techniques are efficient in treating stres incontinence in women, with differences like increased post-void residue in TOT, but with a lower rate of imediate and late postoperative complications for the same technique. Both surgical techinqes can induce dysuria, but mixed or urged rezidual incontinence where more frequent in the patients who underwent surgery using TVT technique.