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KMID : 0358420080510060650
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Korean Journal of Obstetrics and Gynecology
2008 Volume.51 No. 6 p.650 ~ p.658
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A comparative study of two transobturator tape procedures: "Outside-in" (TOT) and "inside-out" (TVT-O) for surgical treatment of female stress urinary incontinence
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Kim Young-Sang
Shin Ji-Eun
Kim Hyun-Chul
Chang Sung-Woon
Cho Jin-Ho
Lee Chung-No
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Abstract
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Objective: To compare the outcomes of the ’outside-in’ (TOT) and ‘inside-out’ (TVT-O) transobturator tape procedures for surgical treatment of female urinary incontinence.
Methods: We enrolled 320 stress urinary incontinence women who could be followed-up and they underwent the TOT procedure (N=184) and TVT-O procedure (N=136) from January 1, 2003 to June 30, 2006. The preoperative evaluation included a history taking, physical examination, residual urine check, pad test, Q-tip test and urodynamic test. And we investigated the patients’ characteristics, success rates, operation times, concomitant surgeries, hospital days, hemoglobin changes and complications.
Results: There were no statistically significant differences in patients’ characteristics and urodynamic tests except the intrinsic sphincter deficiency rate (ISD: 5.6% vs. 30.6%, p=0.000). The success rates were similar in both groups (98.4% vs. 97.8%). Most common complication of TOT group is operation site erosion (2.1%), and TVT-O group is thigh or vaginal pain (3.6%). There were noted other complications, such as postoperative urinary retention, de novo urgency and urinary tract infection. Total complication rates of both groups were not statistically different (7.6% vs. 9.5%, p=0.415). There were no statistic differences in the postoperative complication rates of between only TOT group and TOT with colporrhaphy group (p=0.371), also between only TVT-O group and TVT-O with colporrhaphy group (p=0.692). There were no correlation with ISD and postoperative complications in TOT (p=0.373) and TVT-O group (p=0.082).
Conclusions: The two procedures of transobturator tape procedure for female stress urinary incontinence appear to be equally effective and safe. However, long-term follow-up, surgeons’ learning course, skill and experience for transobturator tape procedures should be evaluated at further studies.
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KEYWORD
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TOT, TVT-O, Stress urinary incontinence, Transobturator tape procedure
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