Comparison of short term results of TVT-O and TVT-S in the surgical treatment of stress urinary incontinence

Czech version

Authors: J. Mašata ¹; K. Švabík ¹; K. Zvára ²; P. Drahodrádová ¹; P. Hubka ¹; R. Elhaddad ¹; A. Martan ¹
Authors‘ workplace: Gynekologicko-porodnická klinika VFN a 1. LF. UK, Praha, přednosta prof. MUDr. A. Martan, DrSc. ¹; Euromise Centrum, Oddělení medicínské informatiky, Ústav informatiky Akademie věd ČR, Praha, ředitelka prof. RNDr. J. Zvárová, DrSc. ²
Published in: Ceska Gynekol 2012; 77(4): 350-357

Overview

Objective of the study:
To compare short term results of tensionfree vaginal tape – obturator (TVT-O) and the tension free vaginal tape Seccure in the treatment of urodynamic stress urinary incontinence (USI).

Design:
Randomize trial.

Settings:
Department of Gynecology and Obstetrics, First Medical Faculty, Charles University; General Teaching Hospital, Prague.

Material and methods:
This single-centre randomized three-arm trial compared the objective and subjective efficacy and early failure rate of the TVT-O and TVT-S H and U approach by objective criteria (cough test) and subjective criteria using the International Consultation on Incontinence Questionnaire-Short form (ICIQ-UI SF). The objective efficacy rate was defined as the number of patients with a negative cough stress test. Subjective cure was defined by no stress leakage of urine after surgery based on evaluation of ICIQ – UI SH (when patients ticked “Never” / “Urine does not leak” in answer to Question 6: When does urine leak?).

Results:
197 women with proved SUI were randomized into three groups – TVT-O (68), TVT-S H (64) and TVT-S U (65). Each patient allocated to a treatment group received the planned surgery. There were no differences in each group in pre-operative characteristics. Three months after surgery were analyzed 65 women in TVT-O group, 61 in TVT-S H and 60 in TVT-S U. 95.4% subjects in the TVT-O group, 82% in the TVT-S H group and 76.7% in the TVT-S U group had stress test negative (p=0.006). 90.8% subjects in the TVT-O group, 82% in the TVT-S H group and 78.3% in the TVT-S U group were subjectively continent (NS).

Conclusions:
Our study demonstrated a significantly lower objective cure rate in the single incision TVT S group compared to the TVT-O group three months after surgery.

Key words:
stress urinary incontinence, TVT-O, TVT-S.

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