Urogynecology Unit, Department of Obstetrics and Gynecology, Western Galilee Hospital, Nahariya, Israel.
Technion Faculty of Medicine, Haifa, Israel; Research and Development in Urogynecology, the CEO's Office, Shaare-Zedek Medical Center, Jerusalem, Israel.
To compare related pain and cure using the transobturator and single-incision suburethral mini-sling anti-incontinence operations.
Open, prospective, nonrandomized 2-armed study comparing 2 surgical procedures for treatment of female stress urinary incontinence (Canadian Task Force classification II-1).
Setting: A university and a private hospital.
One hundred sixty-two women with stress urinary incontinence underwent either a tension-free vaginal tape-obturator (TVT-O) or a single-incision (TVT-SECUR) suburethral or mid-urethral tape operation.
Pain levels were estimated using a visual analog scale, and outcome using the Urinary Distress Inventory and the Incontinence Impact Questionnaire. Postoperative vaginal and thigh pain was transient, lasting for up to 2 weeks, and occurred significantly more frequently in the TVT-O group (32% vs 1% and 32% vs 0%, respectively). Dyspareunia was not self-limited, and occurred more frequently in the TVT-SECUR group (7.9% vs 0%). Cure rates were 86.9% in the TVT-O group and 90.9% in the TVT-SECUR group. Complication rates were similar in the 2 groups.
Both procedures were effective, with few adverse effects. In sexually inactive patients, the TVT-SECUR procedure may be preferable because thigh and vaginal pain is largely averted with this procedure. Sexually active patients might be better referred for the TVT-O procedure because it was not followed by dyspareunia in our series. Patient choice of surgical method rather than randomization weakened the strength of this study.
Written by:
Neuman M, Sosnovski V, Kais M, Ophir E, Bornstein J. Are you the author?
Reference: J Minim Invasive Gynecol. 2011 Nov;18(6):769-73.
doi: 10.1016/j.jmig.2011.08.718
PubMed Abstract
PMID: 22024263
UroToday.com Stress Urinary Incontinence Section
