What surgical treatments are available for stress incontinence?

Objectives:

To compare tension-free vaginal tape (TVT) and trans-obturator suburethral tape from inside to outside (TVT-O) for surgical treatment of stress urinary incontinence (SUI) for complications (primary end point) and success rate (secondary end point).

Methods:

Seventy-two consecutive patients, with a mean age of 53.2 yr (range: 38-69 yr) and affected by SUI, were included in this randomised controlled trial. After preoperative assessment, patients were randomly allocated to the TVT or TVT-O procedure. Operative time, perioperative complications, and hospital stay were prospectively recorded. Cure of SUI was defined as no leakage of urine during the stress test at urodynamic testing at the 12-mo evaluation. The Wilcoxon signed rank sum test, Mann-Whitney U test, McNemar test, and Fisher exact test were used to verify statistical significance, set at p<0.05.

Results:

All patients were evaluable at the 12-mo follow-up. The characteristics of patients were well balanced between groups after randomisation. The mean operative time was significantly shorter in the TVT-O group. Perioperative complications were significantly more common after the retropubic approach (5% and 27% in TVT-O and TVT groups, respectively, p<0.04). The groups did not differ significantly in intraoperative blood loss, hospital stays, and time to return to normal activities. Sixty-five patients (90%) were successfully treated for SUI 12 mo after the operation (89% and 91% for TVT-O and TVT groups, respectively).

Conclusions:

Both techniques appear to be equally effective in the surgical treatment of SUI. However, TVT-O had a shorter operative time and lower overall perioperative complication rate.

Please click on the required question.

• 1  How is urine produced?
• 2  What is cystitis?
• 3  How prevalent is cystitis?
• 4  What is honeymoon cystitis?
• 5  What are Frequency and nocturia?
• 6  How prevalent are Frequency and nocturia?
• 7  What is urinary incontinence?
• 8  What is stress incontinence of urine?
• 9  What is urgency, urge incontinence and the urge syndrome?
• 10 What causes stress and urge incontinence?
• 11 What is dribbling incontinence?
• 12 How prevalent is urinary incontinence?
• 13 What is the urethral syndrome?
• 14 How can I record my bladder problems and monitor the effects of treatment?
• 15 What simple measures are available to reduce urinary incontinence?
• 16 What are pelvic floor exercises?
• 17 How successful are pelvic floor exercises?
• 18 What is bladder training?
• 19 How effective is bladder training?
• 20 Are there any alternatives to bladder training for urgency symptoms?
• 21 If simple measures do not suffice, what else is available for the treatment of urinary stress incontinence?
• 22 What are urodynamic studies?
• 23 Where can I obtain further information about bladder problems?
• 24 Support Groups.

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