The comparison of two minimal invasive surgeries, the tension-free vaginal tape (TVT) and the transobturator tape (TOT) in terms of efficiency and the complications

Aim To examine the outcomes of two most frequently usedoperative techniques of the urinary incontinence.Methods A retrospective analysis of medical records of patientswere applied among randomly selected 400 women sufferingfrom stress-incontinence or mixed-type incontinence. Thepatients underwent tension-free vaginal tape (TVT) (200 patients)and transobturator tape (TOT) (200 patients) operationin three Hungarian hospitals between 2002 and 2006. Patientswere divided into two groups based on type of surgery. Themain outcome measure were complications of the treatment.Results As far as efficiency is concerned there was not significantdifference between the two surgeries, TVT and TOT, 81.5%and 88.0%, respectively (p=0.0705). A significantly highercomplication rate in women with TVT surgery compared toTOT was found; bladder injury: TVT 4.0% vs. TOT 0.5%(p=0.0182), abdominal pain: 30.5% vs. 16.0% (p=0.0005),dysuria: TVT 21,0% vs. TOT 13,0% (p=0.0331), urinarytract infections: TVT 13.5% vs. TOT 6.5% (p=0.0196), retention:TVT 7.5% vs. TOT 1.0% (p=0.0012); furthermorethe operative time was longer (p<0.001). The average lengthof catheter use (p<0.001) and hospital stay were also longer inTVT (p<0.001). In case of TOT surgery, a significantly higherrate of vaginal erosion was found (TVT 0.0% vs. TOT 4.0%,p=0.0413).Conclusions Both types of minor surgical interventions can beconsidered as efficient ways of treating incontinence but in caseof TOT the number of nursing days decreased significantlywith less complications. The patients could start work earlierafter the surgery. Therefore, from economic and social aspectTOT is remarkably more favourable.