Randomized controlled trial comparing TVT-O and TVT-S for the treatment of stress urinary incontinence: 2-year results

Randomized controlled trial comparing TVT-O and TVT-S for the treatment of stress urinary incontinence: 2-year results

Author Bianchi-Ferraro, Ana Maria H. M. Autor UNIFESP Google Scholar
Jarmy-DiBella, Zsuzsanna I. K. Autor UNIFESP Google Scholar
Castro, Rodrigo de Aquino Autor UNIFESP Google Scholar
Bortolini, Maria Augusta T. Autor UNIFESP Google Scholar
Sartori, Marair G. F. Autor UNIFESP Google Scholar
Girao, Manoel J. B. C. Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract The aim was to compare the efficacy and safety of single-incision sling TVT-Secur (TVT-S) and transobturator midurethral sling (TVT-O) for the treatment of stress urinary incontinence (SUI) over 2 years' follow-up.This is a randomized controlled trial in which women with SUI were randomly assigned to have either TVT-O (n = 56) or TVT-S (n = 66). Exclusion criteria included: voiding dysfunction, detrusor overactivity, and pelvic organ prolapse beyond the hymen. the primary outcomes were objective and subjective cure rates at a follow-up visit at 24 months, defined as a negative stress test and pad test as well as absence of self-reported SUI symptoms. Secondary endpoints included quality of life assessment using the King's Health Questionnaire (KHQ), and complication and reoperation rates. Analysis was performed using intention to treat, and statistical significance was fixed at 5 % (p < 0.05). Statistical methods used were Mann-Whitney, Student's t, Chi-squared, Fisher's, ANOVA, and McNemar's tests.The groups were similar regarding demographic and clinical preoperative parameters. Objective cure rates for TVT-S and TVT-O groups were 77.3 % and 83.6 %, while subjective cure rates were 75.7 % and 80.3 % respectively, with no statistically significant differences between the techniques. There was a significant improvement in all KHQ domains in both groups (p < 0.001). A few complications were observed in our study. the most common perioperative complication was thigh pain associated with TVT-O, while the long-term one was tape exposure observed in 5.3 % of TVT-O and in 7.5 % of TVT-S cases.The efficacy of the TVT-S was similar to that of the TVT-O after 2 years' assessment. This cohort will continue to be followed in order to maintain commitment to contributing data on long-term results.
Keywords Mini-sling
Single incision sling
Stress urinary incontinence
SUI surgery
Transobturator sling
TVT-Secur
Language English
Sponsor Federal University of São Paulo
Date 2014-10-01
Published in International Urogynecology Journal. London: Springer London Ltd, v. 25, n. 10, p. 1343-1348, 2014.
ISSN 0937-3462 (Sherpa/Romeo, impact factor)
Publisher Springer
Extent 1343-1348
Origin http://dx.doi.org/10.1007/s00192-014-2352-7
Access rights Closed access
Type Article
Web of Science ID WOS:000342338400008
URI http://repositorio.unifesp.br/handle/11600/38264

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