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TVT-O vs TVT: a randomized trial in patients with different degrees of urinary stress incontinence

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Abstract

TVT-O and TVT were compared in patients stratified according the severity of Stress Urinary Incontinence (SUI). Those patients with intrinsic sphincter deficiencies, overactive bladders, associated prolapses, neurovegetative disorders and recurrent SUI or under rehabilitative/medical therapies were all excluded. There were 208 women included. Operating times were longer, and postoperative pain greater for TVT (p < 0.001). TVT produced longer hospitalizations in severe SUI patients (p < 0.001). After 1 year of follow-up, incontinence was cured in all mild SUI patients with both techniques, in all severe SUI patients when treated with TVT and in 66% of them when treated with TVT-O (p < 0.001). Vaginal perforations occurred during the TVT-O (p = 0.01), bladder perforations during TVT (p = NS), bladder obstructions in mild SUI patients after TVT (p < 0.001). The severity of SUI is an important parameter that influences results after TVT-O and TVT, and could be used to guide surgeons in selecting the most effective intervention.

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Authors and Affiliations

  1. Section of Gynecology and Obstetrics, Department of Surgery, School of Medicine, “Tor Vergata” University Hospital, Viale Oxford 81, 00133, Rome, Italy

    F. Araco, F. Sesti & E. Piccione

  2. Department of Surgery, Whipps Cross University Hospital, London, UK

    G. Gravante

  3. Department of Human Physiology, Laboratory of Biometry, University of Tor Vergata, via Montpellier 1, 00133, Rome, Italy

    R. Sorge

  4. Barts and the London School of Medicine and Dentistry, London, UK

    J. Overton

  5. Section of Obstetrics and Gynecology, S.Francesco D’Assisi Hospital, Oliveto Citra, Salerno, Italy

    D. De Vita

  6. via U. Maddalena 40/a, Ciampino, 00043, Rome, Italy

    G. Gravante

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  1. F. Araco
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  2. G. Gravante
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  3. R. Sorge
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  4. J. Overton
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  5. D. De Vita
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  6. F. Sesti
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Correspondence to G. Gravante.

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Araco, F., Gravante, G., Sorge, R. et al. TVT-O vs TVT: a randomized trial in patients with different degrees of urinary stress incontinence. Int Urogynecol J 19, 917–926 (2008). https://doi.org/10.1007/s00192-007-0554-y

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  • DOI: https://doi.org/10.1007/s00192-007-0554-y

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