Incontinence Research Today is a free monthly online journal that collates and summarizes the latest research about Incontinence, including details on urinary incontinence, bladder control, treatment, causes.

Ultrasonographic assessment of tape location following tension-free vaginal tape and transobturator tape procedure.

Long CY, Hsu CS, Lo TS, Liu CM, Chen YH, Tsai EM

Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

BACKGROUND: The purpose of this study was to perform an ultrasonographic comparison of tension-free vaginal tape (TVT) and the TVT-obturator (TVT-O) procedure in women with stress urinary incontinence (SUI). METHODS: We retrospectively reviewed 159 women with SUI undergoing either TVT (n=91) or TVT-O (n=68). All subjects underwent perineal ultrasonographies, pelvic examination, urinalyses, 1-h pad tests, multichannel urodynamic studies and a personal interview using the Bristol Female Lower Urinary Tract Symptoms Questionnaire before and 1 year after surgery. RESULTS: At rest or during Valsalva, the middle of the TVT-O tape localised more distally than the TVT on ultrasound (p<0.01). A higher rate of urethral kinking during straining was observed in the TVT group compared with the TVT-O group after surgery (86.9 versus 23.9%, p<0.01). Mean operative time was significantly shorter in the TVT-O group (16.2 versus 28.6 min, p<0.01). The rate of objective cure was comparable for the TVT and TVT-O groups (94.5 versus 88.2%, p<0.05). However, subjective cure rate was significantly lower for the TVT-O than the TVT group (82.4 versus 93.4%, p=0.042). There was no statistical difference between the 2 groups regarding patient characteristics and complication rates. CONCLUSIONS: TVT-O tape results in a less acute angle and localises to a more distal part of the urethra, resulting in less urethral compression and a lower rate of urethral dynamic kinking.

Published 25 December 2007 in Acta Obstet Gynecol Scand, 87(1): 116-21.
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