Tension-Free Vaginal Tape versus Transobturator Tape for Treatment of Female Stress Urinary Incontinence

Objectives: The transobturator tape (TOT) is based on a similar principle as the tension-free vaginal tape (TVT), but introduced through the obturator foramen. The aim of this study was to compare these slings as surgical procedures for the treatment of stress urinary incontinence (SUI) in women. Patients and Methods: This is a retrospective case-control study including female patients with SUI, either due to urethral hypermobility or intrinsic sphincter deficiency. Thirty patients were treated with TVT (group 1) and 30 were treated with TOT (group 2). The parameters studied were: pre-operative clinical data, operative data and surgical outcome. Results: The post-operative complications in group 1 consisted of bladder perforation in one patient (3.3%), urinary retention in 3 (10%) and de novo urgency in 3 (10%). The post-operative complications in group 2 consisted of vaginal exposure in 2 patients (6.7%), de novo urgency in 2 (6.7%) and transient urinary retention in one (3.3%). In the TVT group, objective cure was achieved in 27/30 patients (90%), while 3 patients (10%) reported subjective cure; failure was not encountered. In the TOT group, objective cure was achieved in 24/30 patients (80%) and subjective cure in 4 patients (13.3%); and it failed in 2 patients (6.7%). Conclusion: TVT and TOT are effective procedures for the treatment of female SUI, with comparable results regarding operative time, hospital stay and the risk of complications.