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Twelve months effect on voiding function of retropubic compared with outside-in and inside-out transobturator midurethral slings

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Abstract

Introduction and hypothesis

The purpose of this study is to compare retropubic tension-free vaginal tape (TVT) with transobturator out-in TOT and in-out TVT-O for female stress urinary incontinence. Uroflow rate was primary; continence rates, quality of life (QoL) and complication pattern were secondary endpoints.

Methods

A prospective randomised trial with 2:1:1 randomisation at two Swiss teaching hospitals. Patients were followed up at 12 months.

Results

Eighty TVT, 40 transobturator tape (TOT) and 40 TVT-O were randomised. At 12 months, there was no difference in Qmax among the groups. Continence was comparable (≥89%). QoL was improved significantly in all groups (P < 0.05). Five vaginal tape exposures occurred (one TVT, four TOT, zero TVT-O; P = 0.028). Two percent (1/52) of sexually active patients after TVT, 17% (5/29) after TOT, but 0% (0/25) after TVT-O reported de novo female sexual dysfunction (P = 0.011). We considered this clinically important enough to stop enrolment.

Conclusions

There was no difference for Qmax at 12 months between TVT, TOT and TVT-O. Female sexual dysfunction and tape exposure may be higher with a transobturator tape.

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Acknowledgements

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No funding received.

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Authors and Affiliations

  1. Department of Gynecology, University Hospital Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland

    David A. Scheiner, Cornelia Betschart, Sandra Wiederkehr, Daniel Fink & Daniele Perucchini

  2. Obstetrics and Gynecology, Cantonal Hospital Uri, Altdorf, Switzerland

    Cornelia Betschart

  3. Division of Biostatistics, ISPM, University of Zurich, Zurich, Switzerland

    Burkhardt Seifert

Authors
  1. David A. Scheiner
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  2. Cornelia Betschart
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  3. Sandra Wiederkehr
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  4. Burkhardt Seifert
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  5. Daniel Fink
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  6. Daniele Perucchini
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Corresponding author

Correspondence to David A. Scheiner.

Additional information

David Scheiner and Cornelia Betschart contributed equally to this study.

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Scheiner, D.A., Betschart, C., Wiederkehr, S. et al. Twelve months effect on voiding function of retropubic compared with outside-in and inside-out transobturator midurethral slings. Int Urogynecol J 23, 197–206 (2012). https://doi.org/10.1007/s00192-011-1543-8

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  • DOI: https://doi.org/10.1007/s00192-011-1543-8

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