›› 2012, Vol. 32 ›› Issue (4): 412-.doi: 10.3969/j.issn.1674-8115.2012.04.009

• Monographic report (Urinary dysfunction and pelvic reconstruction) • Previous Articles     Next Articles

Efficacy and complications of TVT procedure and TVT-O procedure in treatment of female stress urinary incontinence

CHEN Hui-xing1,2, LV Jian-wei1, LENG Jing1, LI Jia-yi1, BO Juan-jie1, HUANG Yi-ran1   

  1. 1.Department of Urology, Renji Hospital, Center of Urinary Incontinence and Pelvic Reconstruction, Shanghai Jiaotong University School of Medicine, Shanghai 200001, China；2.Department of Urology, Pudong Hospital, Shanghai 200125, China
  • Online:2012-04-28 Published:2012-04-27

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Abstract:

Objective To compare the clinical efficacy and complications of tension-free vaginal tape (TVT) procedure (TVT group) and transobturator vaginal tape inside out (TVT-O) procedure (TVT-O group) in treatment of female stress urinary incontinence (SUI). Methods Two hundred and five female patients with SUI were randomized to receive TVT procedure (n=102) or TVT-O procedure (n=103) from February 2009 to February 2010, and the clinical efficacy and complications were compared. Results The mean time of operation in TVT group was (27.5±13.3) min (25 to 45 min), the mean time of operation in TVT-O group was (18.5±7.4) min (11 to 25 min), and there were significant differences between two groups (P<0.05). There was no significant difference in the volume of blood loss during operation, mean duration of indwelling catheter, average length of hospital stay and volume of postoperative residual urine between two groups (P>0.05). The symptoms of urinary incontinence in 195 patients (95.1%) in two groups were controlled after operation, and no incidence of urinary incontinence occurred during the follow-up for 12 to 24 months. There were 5 patients (4.9%) with intraoperative bladder injury and 2 patients (2.0%) with urinary retention after catheter removal in TVT group. There were 2 patients (2%) with urinary retention after catheter removal, 3 patietns (2.9%) with postoperative thigh pain and no case of bladder injury in TVT-O group. There was no symptom of urinary incontinence within 6 months after operation in 4 patients (3.8%), moderate urinary incontinence emerged 12 months after operation, and the symptoms improved in all the 4 patients. Conclusion TVT procedure and TVT-O procedure are effective and reliable in treatment of female SUI. TVT procedure has better long-term effect and higher possibility of bladder injury than TVT-O procedure. TVT-O procedure is simpler than TVT procedure, with less surgical trauma, less complications and occasionally-occurred thigh pain. The mid-term clinical efficacy of TVT-O procedure is slightly worse than that of TVT procedure.

Key words: tension-free vaginal tape, transobturator vaginal tape inside out, stress urinary incontinence