Skip to main content

Advertisement

SpringerLink
Log in

TVT vs. TOT: a comparison in terms of continence results, complications and quality of life after a median follow-up of 48 months

  • Urology – Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Aim

To compare the tension-free vaginal tape (TVT) and obturator tape (TOT) procedures in terms of continence results, complications and quality of life after a median follow-up of 48 months.

Patients and methods

Two hundred and eight female patients suffering from urodynamically proven urinary incontinence underwent TVT or TOT. The clinicopathologic parameters of the patients included age, body mass index, type of incontinence, onset of incontinence, previous pelvic surgery, parity, menopausal statement, perioperative and postoperative complications and outcome in terms of continence and quality of life.

Results

TVT was performed on 48.6% of patients and TOT on 51.4%. The median age was 63.4 and median follow-up period was 48 months. Prior to surgery, stress urinary incontinence (SUI) was diagnosed in 75.7% of patients and mixed incontinence (SUI and urge incontinence) with a predominant SUI in 24.3%. An objective cure rate in patients who underwent TOT was observed in 77.7% of cases and in those who underwent TVT in 81%. The quality of life improved in 80% of cases. There was no significant difference between the procedures in terms of continence results and quality of life. The rate of the complications was significantly higher with the TVT procedure when compared to that of the TOT procedure.

Conclusions

Although there were no significant differences between the two types of procedures in terms of continence results and quality of life, the TOT procedure demonstrates significantly better results in terms of the rate of complications, making it, if indicated, our first choice.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ulmsten U (1997) Some reflections and hypotheses on the pathophysiology of female urinary incontinence. Acta Obstet Gynecol Scand 166(Suppl):3–8

    CAS  Google Scholar 

  2. Nilsson CG, Palva K, Rezapour M, Falconer C (2008) Eleven years prospective follow-up of the tension-free vaginal tape procedure for treatment of stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 19:1043–1047

    Article  CAS  PubMed  Google Scholar 

  3. Karram MM, Segal JL, Vassallo BJ, Kleeman SD (2003) Complications and untoward effects of the tension-free vaginal tape procedure. Obstet Gynecol 101:929–932

    Article  PubMed  Google Scholar 

  4. Delorme E, Droupy S, de Tayrac R, Delmas V (2004) Transobturator tape (Uratape®): a new minimally-invasive procedure to treat female urinary incontinence. Eur Urol 45:724–730

    Article  Google Scholar 

  5. Bump RC, Mattiasson A, Bo K (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17

    Article  CAS  PubMed  Google Scholar 

  6. Wadie BS, El-Hefnawy AS (2009) Urethral pressure measurement in stress incontinence: does it help? Int Urol Nephrol 41(3):491–495

    Article  PubMed  Google Scholar 

  7. Uebersax JS, Wyman JF, Shumaker SA, McClish DK, Fantl JA (1995) Short forms to assess life quality and symptom distress for urinary incontinence in women: the incontinence impact questionnaire and urogenital distress inventory. NeurourolUrodyn 14:131–139

    CAS  Google Scholar 

  8. Konstantinos H, Eleni K, Dimitrios H (2006) Dilemmas in the management of female stress incontinence: the role of pelvic floor muscle training. Int Urol Nephrol 38(3–4):513–525

    PubMed  Google Scholar 

  9. Zahariou A, Karamouti M, Karagiannis G, Papaioannou P (2008) Maximal bladder capacity is a positive predictor of response to desmopressin treatment in patients with MS and nocturia. Int Urol Nephrol 40(1):65–69

    Article  CAS  PubMed  Google Scholar 

  10. Metin A, Kayigil O, Ahmed SI, Atmaca AF (2008) Is the efficacy of in situ vaginal wall slings decreasing in the late follow-up? Int Urol Nephrol 40(1):51–55

    Article  PubMed  Google Scholar 

  11. Waltregny D, de Leval J (2009) The TVT-obturator surgical procedure for the treatment of female stress urinary incontinence: a clinical update. Int Urogynecol J Pelvic Floor Dysfunct 20:337–348

    Article  PubMed  Google Scholar 

  12. Zullo MA, Plotti F, Calcagno M, Marullo E, Palaia I, Bellati F, Basile S, Muzii L, Angioli R, Panici PB (2007) One-year follow-up of tension-free vaginal tape (TVT) and trans-obturator suburethral tape from inside to outside (TVT-O) for surgical treatment of female stress urinary incontinence: a prospective randomised trial. Eur Urol 51:1376–1382

    Article  PubMed  Google Scholar 

  13. Barber MD, Kleeman S, Karram MM, Paraiso MF, Walters MD, Vasavada S, Ellerkmann M (2008) Transobturator tape compared with tension-free vaginal tape for the treatment of stress urinary incontinence: a randomized controlled trial. Obstet Gynecol 111:611–621

    Article  PubMed  Google Scholar 

  14. Liapis A, Bakas P, Giner M, Creatsas G (2006) Tension-free vaginal tape versus tension-free vaginal tape obturator in women with stress urinary incontinence. Gynecol Obstet Invest 62(3):160–164

    Article  PubMed  Google Scholar 

  15. deTayrac R, Deffieux X, Droupy S, Chauveaud-Lambling A, Calvanèse-Benamour L, Fernandez H (2004) A prospective trial comparing tension-free vaginal tape and transobturator suburethral tape for surgical treatment of stress urinary incontinence. AJOG 190(3):602–608

    Article  Google Scholar 

  16. Paick JS, Oh JG, Shin JW, Kim SW, Ku JH (2007) Does the degree of experience for the tension-free vaginal tape procedure influence the results of the suprapubic arc sling procedure during the learning phase? Int Urol Nephrol 39(4):1079–1084

    Article  PubMed  Google Scholar 

  17. Daneshgari F, Kong W, Swartz M (2008) Complications of mid urethral slings: important outcomes for future clinical trials. J Urol 180(5):1890–1897

    Article  PubMed  Google Scholar 

  18. Minaglia S, Ozel B, Klutke C, Ballard C, Klutke J (2004) Bladder injury during transobturator sling. Urology 64:376–377

    Article  PubMed  Google Scholar 

  19. El-Barky E, El-Shazly A, El-Wahab OA, Kehinde EO, Al-Hunayan A, Al-Awadi KA (2005) Tension free vaginal tape versus Burch colposuspension for treatment of female stress urinary incontinence. Int Urol Nephrol 37(2):277–281

    Article  PubMed  Google Scholar 

  20. Lee KS, Han DH, Choi YS, Yum SH, Song SH, Doo CK, Choo MS (2007) A prospective trial comparing tension-free vaginal tape and transobturator vaginal tape inside-out for the surgical treatment of female stress urinary incontinence: 1-year follow up. J Urol 177(1):214–218

    Article  PubMed  Google Scholar 

  21. Mustafa M, Wadie BS (2007) Bladder erosion of tension-free vaginal tape presented as vesical stone; management and review of literature. Int Urol Nephrol 39(2):453–455

    Article  PubMed  Google Scholar 

  22. Moore RD, Gamble K, Miklos JR (2007) Tension-free vaginal tape sling for recurrent stress incontinence after transobturator tape sling failure. Int Urogynecol J Pelvic Floor Dysfunct 18:309–313

    Article  PubMed  Google Scholar 

  23. de Leval J (2003) Novel surgical technique for the treatment of female stress urinary incontinence: transobturator vaginal tape inside-out. Eur Urol 44:724–730

    Article  PubMed  Google Scholar 

  24. Kulseng-Hanssen S, Husby H, Schiøtz HA (2008) Follow-up of TVT operations in 1, 113 women with mixed urinary incontinence at 7 and 38 months. Int Urogynecol J Pelvic Floor Dysfunct 19:391–396

    Article  PubMed  Google Scholar 

  25. Hellberg D, Holmgren C, Lanner L, Nilsson S (2007) The very obese woman and the very old woman: tension-free vaginal tape for the treatment of stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 18:423–429

    Article  PubMed  Google Scholar 

  26. Koops SE, Bisseling TM, van Brummen HJ, Heintz AP, Vervest HA (2006) What determines a successful tension-free vaginal tape? A prospective multicenter cohort study: results from The Netherlands TVT database. Am J Obstet Gynecol 194:65–74

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology and Pediatric Urology, Prostatazentrum Nordwest, St. Antonius-Hospital, Möllenweg 22, 48599, Gronau, Germany

    Vahudin Zugor & Jörn Witt

  2. Department of Urology, Martha Maria Medical Center, Nurnberg, Germany

    Apostolos P. Labanaris

  3. Department of Urology, Salzgitter Medical Center, Salzgitter, Germany

    Mohammad-Reza Rezaei-Jafari, Joachim Dembowski & Wigand Wucherpfennig

  4. Department of Urology, Braunschweig Medical Center, Braunschweig, Germany

    Peter Hammerer

Authors
  1. Vahudin Zugor
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Apostolos P. Labanaris
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mohammad-Reza Rezaei-Jafari
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Peter Hammerer
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Joachim Dembowski
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jörn Witt
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Wigand Wucherpfennig
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Vahudin Zugor.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zugor, V., Labanaris, A.P., Rezaei-Jafari, MR. et al. TVT vs. TOT: a comparison in terms of continence results, complications and quality of life after a median follow-up of 48 months. Int Urol Nephrol 42, 915–920 (2010). https://doi.org/10.1007/s11255-010-9708-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-010-9708-9

Keywords

Search

Navigation