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Twelve months effect on voiding function of retropubic compared with outside-in and inside-out transobturator midurethral slings

Scheiner, David ; Betschart, Cornelia ; Wiederkehr, Sandra ; Seifert, Burkhardt ; Fink, Daniel ; Perucchini, Daniele

In: International Urogynecology Journal, 2012, vol. 23, no. 2, p. 197-206

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    Titre
    • Twelve months effect on voiding function of retropubic compared with outside-in and inside-out transobturator midurethral slings
    Auteur
    • Scheiner, David. Department of Gynecology, University Hospital Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland
    • Betschart, Cornelia. Department of Gynecology, University Hospital Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland
    • Wiederkehr, Sandra. Department of Gynecology, University Hospital Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland
    • Seifert, Burkhardt. Division of Biostatistics, ISPM, University of Zurich, Zurich, Switzerland
    • Fink, Daniel. Department of Gynecology, University Hospital Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland
    • Perucchini, Daniele. Department of Gynecology, University Hospital Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • International Urogynecology Journal, 2012, vol. 23, no. 2, p. 197-206. Springer-Verlag
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:310928
    Summary
    Introduction and hypothesis: The purpose of this study is to compare retropubic tension-free vaginal tape (TVT) with transobturator out-in TOT and in-out TVT-O for female stress urinary incontinence. Uroflow rate was primary; continence rates, quality of life (QoL) and complication pattern were secondary endpoints. Methods: A prospective randomised trial with 2:1:1 randomisation at two Swiss teaching hospitals. Patients were followed up at 12months. Results: Eighty TVT, 40 transobturator tape (TOT) and 40 TVT-O were randomised. At 12months, there was no difference in Qmax among the groups. Continence was comparable (≥89%). QoL was improved significantly in all groups (P < 0.05). Five vaginal tape exposures occurred (one TVT, four TOT, zero TVT-O; P = 0.028). Two percent (1/52) of sexually active patients after TVT, 17% (5/29) after TOT, but 0% (0/25) after TVT-O reported de novo female sexual dysfunction (P = 0.011). We considered this clinically important enough to stop enrolment. Conclusions: There was no difference for Qmax at 12months between TVT, TOT and TVT-O. Female sexual dysfunction and tape exposure may be higher with a transobturator tape