Clinical Comparison between Tension-Free Vaginal Tape and Tension-Free Vaginal Tape-obturator for Female Stress Urinary Incontinence_West China Medical Journal

Authors：

 YUANDan , XUYan , ZHUShu-xia , WANGYu , LIUDong-liang

Department of Urology, Chengdu 363 Hospital Affiliated to Luzhou Medical College, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

Keywords：

Female stress urinary incontinence; Tension-free vaginal tape; Tension-free vaginal tape-obturator

DOI：

10.7507/1002-0179.20140515

Video：

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Objective To compare the clinical outcome of tension-free vaginal tape (TVT) and TVT-obturator (TVT-O) for female stress urinary incontinence (SUI). Methods Sixty-one female SUI patients were included in our study, in which 33 received TVT procedure and 28 received TVT-O procedure. The patients were followed up for 1 to 62 months post-operatively, averaging at 22 months. Cure was defined as no leakage during the stress test and no residual urine showed by B ultrasound, improvement as less leakage during the stress test after operation, and inefficacy as leakage during the stress test and no difference was detected after operation. Results Age and disease course were not significantly different between the two groups (P>0.05). All patients underwent TVT or TVT-O procedure successfully. Time of TVT ranged from 26 to 45 min averaging at (35.5±4.3) minutes, and it was significantly different from the time of TVT-O which ranged from 15 to 20 min averaging at (7.2±3.1) minutes (P<0.05). Bleeding during the surgery was not significantly different between the two groups (P>0.05). The rate of complications occurring during TVT-O procedure was significantly less and milder than that during the TVT procedure (P<0.05). The cure rate and improvement rate indicated no significant differences between the two groups (P>0.05). Conclusion The evidence available indicates that TVT and TVT-O procedure are both effective and safe for female SUI. Compared with TVT, TVT-O procedure has the advantages of being more convenient, shorter operation time, being less invasive, and fewer complications, and it may be more suitable for female SUI.

Citation： YUANDan, XUYan, ZHUShu-xia, WANGYu, LIUDong-liang. Clinical Comparison between Tension-Free Vaginal Tape and Tension-Free Vaginal Tape-obturator for Female Stress Urinary Incontinence. West China Medical Journal, 2014, 29(9): 1688-1692. doi: 10.7507/1002-0179.20140515 Copy

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2.	McGuire EJ,Fitzpatrick CC,Wan JL,et al.Re:clinical assessment of urethral sphincter function[J].Int Urogynecol J,1994,5(5):309-310.
3.	金辛良,任淑梅.無張力性陰道吊帶治療女性壓力性尿失禁的臨床療效[J].中華泌尿外科雜志,2005,26(5):337-339.
4.	周芳堅,張時純.女性壓力性尿失禁發病機制和外科治療[J].中華泌尿外科雜志,1999,20(8):57-58.
5.	Leach GE,Dmochowski RR,Appell R,et al.Female stress urinary incontinence clinical guidelines panel summary report on surgical management of female stress urinary incontinence[J].J Urol,1997,158(3):875-880.
6.	DeLancey JO.Structural support of the urethra as it relates to stress urinary incontinence:the hammock hypothesis[J].Am J Obstet Gynecol,1994,170(6):1713-1720.
7.	Mostwin JL,Genadry R,Sanders R,et al.Anatomic goals in the correction of female stress urinary incontinence[J].J Endourol,1996,10(3):207-212.
8.	Niemczyk P,Klutke JJ,Carlin BI,et al.United States experience with tension-free vaginal tape procedure for urinary stress incontinence:assessment of safety and tolerability[J].Tech Urol,2001,7(4):261-265.
9.	Liapis A,Bakas P,Creatsas G.Management of stress urinary incontinence in women with the use of tension-free vaginal tape[J].Eur Urol,2001,40(5):548-551.
10.	de Leval J.Novel surgical technique for the treatment of female stress urinary incontinence:transobturator vaginal tape inside-out[J].Eur Urol,2003,44(6):724-730.
11.	李曉偉,張曉紅,王建六.經閉孔無張力尿道中段懸吊術及其臨床應用[J].國外醫學·婦產科學分冊,2006,33(6):405-407.
12.	Ulmsten U.An introduction to tension-free vaginal tape (TVT):a new surgical procedure for treatment of female urinary incontinence[J].Int Urogynecol J Pelvic Floor Dysfunct,2001,12(Suppl 2):S3-S4.
13.	羅新.陰道無張力尿道中段懸吊術治療女性尿失禁的臨床觀察[J].中華婦產科雜志,2004,39(11):741-743.
14.	陳映鶴,何有華,張磊,等.無張力陰道吊帶術治療壓力性尿失禁出現并發癥的原因[J].臨床泌尿外科雜志,2005,20(1):51-52.
15.	Abouassaly R,Steinberg JR,Lemieux M,et al.Complications of tension-free vaginal tape surgery:a multi-institutional review[J].BJU Int,2004,94(1):110-113.
16.	朱蘭,郎景和,李艷,等.陰道無張力尿道中段懸吊術治療壓力性尿失禁臨床效果分析[J].中國實用婦科與產科雜志,2005,21(3):44-45.
17.	Sola V,Pardo J,Ricci P,et al.TVT versus TVT-O for minimally invasive surgical correction of stress urinary incontinence[J].Int Braz J Urol,2007,33(2):246-252.
18.	Mellier G,Benayed B,Bretones S,et al.Suburethral tape via the obturator route:is the TOT a simplification of the TVT?[J].Int Urogynecol J Pelvic Floor Dysfunct,2004,15(4):227-232.
19.	Bonnet P,Waltregny D,Reul O,et al.Transobturator vaginal tape inside out for the surgical treatment of female stress urinary incontinence:anatomical considerations[J].J Urol,2005,173(4):1223-1228.
20.	Achtari C,Mckenzie BJ,Hiscock R,et al.Anatomical study of the obturator foramen and dorsal nerve of the clitoris and their relationship to minimally invasive slings[J].Int Urogynecol J Pelvic Floor Dysfunct,2006,17(4):330-334.

1. Abrams P,Blaivas JG,Stanton SL,et al.The standardization of terminology of lower urinary tract function recommended by the international continence society[J].Int Urogynecol J,1990,1(1):45-58.
2. McGuire EJ,Fitzpatrick CC,Wan JL,et al.Re:clinical assessment of urethral sphincter function[J].Int Urogynecol J,1994,5(5):309-310.
3. 金辛良,任淑梅.無張力性陰道吊帶治療女性壓力性尿失禁的臨床療效[J].中華泌尿外科雜志,2005,26(5):337-339.
4. 周芳堅,張時純.女性壓力性尿失禁發病機制和外科治療[J].中華泌尿外科雜志,1999,20(8):57-58.
5. Leach GE,Dmochowski RR,Appell R,et al.Female stress urinary incontinence clinical guidelines panel summary report on surgical management of female stress urinary incontinence[J].J Urol,1997,158(3):875-880.
6. DeLancey JO.Structural support of the urethra as it relates to stress urinary incontinence:the hammock hypothesis[J].Am J Obstet Gynecol,1994,170(6):1713-1720.
7. Mostwin JL,Genadry R,Sanders R,et al.Anatomic goals in the correction of female stress urinary incontinence[J].J Endourol,1996,10(3):207-212.
8. Niemczyk P,Klutke JJ,Carlin BI,et al.United States experience with tension-free vaginal tape procedure for urinary stress incontinence:assessment of safety and tolerability[J].Tech Urol,2001,7(4):261-265.
9. Liapis A,Bakas P,Creatsas G.Management of stress urinary incontinence in women with the use of tension-free vaginal tape[J].Eur Urol,2001,40(5):548-551.
10. de Leval J.Novel surgical technique for the treatment of female stress urinary incontinence:transobturator vaginal tape inside-out[J].Eur Urol,2003,44(6):724-730.
11. 李曉偉,張曉紅,王建六.經閉孔無張力尿道中段懸吊術及其臨床應用[J].國外醫學·婦產科學分冊,2006,33(6):405-407.
12. Ulmsten U.An introduction to tension-free vaginal tape (TVT):a new surgical procedure for treatment of female urinary incontinence[J].Int Urogynecol J Pelvic Floor Dysfunct,2001,12(Suppl 2):S3-S4.
13. 羅新.陰道無張力尿道中段懸吊術治療女性尿失禁的臨床觀察[J].中華婦產科雜志,2004,39(11):741-743.
14. 陳映鶴,何有華,張磊,等.無張力陰道吊帶術治療壓力性尿失禁出現并發癥的原因[J].臨床泌尿外科雜志,2005,20(1):51-52.
15. Abouassaly R,Steinberg JR,Lemieux M,et al.Complications of tension-free vaginal tape surgery:a multi-institutional review[J].BJU Int,2004,94(1):110-113.
16. 朱蘭,郎景和,李艷,等.陰道無張力尿道中段懸吊術治療壓力性尿失禁臨床效果分析[J].中國實用婦科與產科雜志,2005,21(3):44-45.
17. Sola V,Pardo J,Ricci P,et al.TVT versus TVT-O for minimally invasive surgical correction of stress urinary incontinence[J].Int Braz J Urol,2007,33(2):246-252.
18. Mellier G,Benayed B,Bretones S,et al.Suburethral tape via the obturator route:is the TOT a simplification of the TVT?[J].Int Urogynecol J Pelvic Floor Dysfunct,2004,15(4):227-232.
19. Bonnet P,Waltregny D,Reul O,et al.Transobturator vaginal tape inside out for the surgical treatment of female stress urinary incontinence:anatomical considerations[J].J Urol,2005,173(4):1223-1228.
20. Achtari C,Mckenzie BJ,Hiscock R,et al.Anatomical study of the obturator foramen and dorsal nerve of the clitoris and their relationship to minimally invasive slings[J].Int Urogynecol J Pelvic Floor Dysfunct,2006,17(4):330-334.

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West China Medical Journal

Clinical Comparison between Tension-Free Vaginal Tape and Tension-Free Vaginal Tape-obturator for Female Stress Urinary Incontinence

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