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

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Abstract

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.

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Authors and Affiliations

  1. Department of Urology, “Hippocratio” General Hospital of Thessaloniki, Thessaloniki, Greece

    S. Charalambous, G. Fatles & V. Rombis

  2. Department of Urology, University Hospital of “Democritus” University of Thrace, Alexandroupoli, Greece

    S. Touloupidis, Ch. Kalaitzis & S. Giannakopoulos

  3. 2nd Department of Urology, School of Medicine, University of Athens, Sismanoglio Hospital, Athens, Greece

    A.G. Papatsoris

  4. Elefteriou Venizelou 30, Agios Vasilios, 26500, Rio-Patra, Greece

    A.G. Papatsoris

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  1. S. Charalambous
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  2. S. Touloupidis
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  3. G. Fatles
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  4. A.G. Papatsoris
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  5. Ch. Kalaitzis
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  6. S. Giannakopoulos
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  7. V. Rombis
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Correspondence to A.G. Papatsoris.

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Charalambous, S., Touloupidis, S., Fatles, G. et al. Transvaginal vs transobturator approach for synthetic sling placement in patients with stress urinary incontinence. Int Urogynecol J 19, 357–360 (2008). https://doi.org/10.1007/s00192-007-0440-7

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  • DOI: https://doi.org/10.1007/s00192-007-0440-7

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