Sequential comparisons of postoperative urodynamic changes between retropubic and transobturator midurethral tape procedures
Journal
World Journal of Urology
Journal Volume
26
Journal Issue
6
Pages
643-648
Date Issued
2008
Author(s)
Abstract
Objectives: To sequentially compare the postoperative urodynamic changes in patients with urodynamic stress incontinence (USI) who underwent tension-free vaginal tape (TVT) or transobturator tape (Monarc TOT) procedure. Methods: Between January 2001 and December 2005, 50 consecutive patients with USI who underwent TVT (n = 24) or TOT (n = 26) procedures were studied, and postoperative urodynamic changes were sequentially compared by one-way ANOVA test with Bonferroni's correction. Results: There were no significant between-group postoperative changes in urodynamic parameters of uroflowmetry, filling and voiding cystometry. However, the TVT group had a higher objective cure rate (100% vs. 69.2%, P = 0.004) by pad test, urethral closure pressure area [40.4 cm2 H2O, 95% confidence interval (CI) = 22.3-58.5 cm2 H2O vs. 3.9 cm2 H2O, 95% CI = -10.9 to 18.7 cm2 H2O, P = 0.036], and continence area (34.4 cm2 H2O, 95% CI = 16.1-52.7 cm2 H2O vs. -3.5 cm2 H2O, 95% CI = -6.7 to 9.8 cm2 H2O, P = 0.001) at 12 months than those of the TOT group. Conclusions: This study demonstrated that tension-free vaginal tape and transobturator tape procedures had no significant difference of impact on bladder voiding and storage functions. However, this study demonstrated that TVT procedure resulted in a higher cure rate with a significantly increased urethral closure pressure area and continence area than did TOT procedure 12 months postoperatively. Thus, TVT procedure might be a better therapeutic choice to achieve continence than TOT. © Springer-Verlag 2008.
SDGs
Type
journal article