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Twelve months effect on voiding function of retropubic compared with outside-in and inside-out transobturator midurethral slings.
MedLine Citation:
PMID:  21887548     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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.
Authors:
David A Scheiner; Cornelia Betschart; Sandra Wiederkehr; Burkhardt Seifert; Daniel Fink; Daniele Perucchini
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-2
Journal Detail:
Title:  International urogynecology journal     Volume:  -     ISSN:  1433-3023     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101567041     Medline TA:  Int Urogynecol J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Gynecology, University Hospital Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland, david.scheiner@usz.ch.
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