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.

Transvaginal vs transobturator approach for synthetic sling placement in patients with stress urinary incontinence.

Charalambous S, Touloupidis S, Fatles G, Papatsoris AG, Kalaitzis Ch, Giannakopoulos S, Rombis V

Department of Urology, Hippocratio General Hospital of Thessaloniki, Thessaloniki, Greece.

We present comparative short-term experience with the transvaginal (TVT) and the transobturator (TVT-O) approaches for the treatment of stress urinary incontinence (SUI). We studied 315 women with SUI, treated with a tension-free tape placement. The TVT approach was applied in 265 women, while 50 women were treated by the TVT-O approach. The mean operation time was 25 and 17 min in the TVT and TVT-O group, respectively (p<0.001). In the TVT group, continence rates were 87% after 1 year, while in the TVT-O group, the continence rate was 94%. Postoperative pain was reported in 14.4 and 28% of the TVT and TVT-O patients, respectively (p=0.02). Complications such as bladder perforation, retropubic hematoma, and urinary retention took place only in the TVT group. Urinary tract infections were recorded in 20 and 8% of the TVT and TVT-O patients, respectively (p=0.04), while vaginal erosion took place in 1.5 and 2% and de novo urgency in 14 and 8%. Both approaches show high rates of cure at the first postoperative year, while complications are less with the TVT-O procedure.

Published 4 February 2008 in Int Urogynecol J Pelvic Floor Dysfunct, 19(3): 357-60.
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