We compared success rates of tension free vaginal tape outside in method (TVT) and tension free transobturator tape outside in method (TOT) in case of female urodynamic stress urinary incontinence at 6 months.
Material and method: 80 patients with urodynamically proven stress urinary incontinence were randomized into TVT (40) and TOT (40) group after excluding urge incontinence and patients with a previous history of incontinence surgery. The outcome of surgical treatment was observed as objective and subjective cure rate and satisfaction score at 6 months.
Results: There was no significant difference between the groups for baseline characteristics. Mean operative time was significantly longer in the TVT group (35.9 min) as compared to TOT group (26.8 min) (p value<0.0001). The mean post void residual urine on the next day of surgery and at 6 months were insignificant (p value>0.05) A case of mesh erosion was diagnosed at 6 months in TOT group. There was no major perioperative complications in either group. Time to return to normal activity were similar in both groups (p value>0.05) of patients. De novo urinary urgency developed in two (5%) patients in TVT group and one (2.5%) patient in TOT group (p value>0.05). The objective and subjective cure rates of TVT and TOT were comparable (85% vs 87.5% and 80% vs 85% respectively).
Conclusion: We concluded that both TVT (outside in) and TOT (outside in) procedures for surgical treatment of stress urinary incontinence were equally efficacious and safe.