Retropubic (TVT) versus transobturator (TVT-O) tension-free vaginal tape: five-year results of the Austrian randomized trial

• Main Authors: Aigmueller, T, Tammaa, A, Hanzal, E, Umek, W, Kropshofer, S, Lang, P, Ralph, G, Riss, P, Koelle, D, Jundt, K, Tamussino, K, Bjelic-Radisic, V
• Format: Conference Proceeding
• Language: eng ; ger
• ISSN: 0016-5751; 1438-8804
• DOI: 10.1055/s-0034-1374751

Objective: Five year results of a randomized controlled trial comparing objective and subjective outcomes of TVT with those of TVT-O as primary treatment for stress urinary incontinence. Methods: Prospective, randomized controlled trial at 25 centers in Austria and Germany ( ClinicalTrials.gov NCT 00441454). Clinical, urodynamic and quality of life assessment was performed preoperatively and 5 years after surgery. Statistical analysis: intention to treat, per protocol; chi-square test, t-test, Fisher's exact test, ANOVA. Results: A total of 569 women were randomized to retropubic or transobturator TVT and 331 patients (60%) were examined at 5 years. No statistical significant differences were seen in negative cough stress (83% vs. 76%, respectively), complications and urodynamic parameters. Quality-of-life parameters improved significantly in both groups, without significant differences between groups. Reoperation rates were 6.1% and 3.2%, erosion rates were 5.2% and 4.1%, respectively. Conclusion : Although the study did not meet its follow-up goal, the long-term results of this randomized trial indicate satisfactory and stable long-term results and improved Quality of Life with both the retropubic and the transobturator TVT. Major long-term problems appear rare.