Comparison of the treatment outcome of pubovaginal sling, tension-free vaginal tape, and transobturator tape for stress urinary incontinence with intrinsic sphincter deficiency

Objective The aim of this study was to compare the treatment outcome of 3 sling procedures for stress urinary incontinence with intrinsic sphincter deficiency. Study Design This retrospective study included 253 patients who underwent incontinence surgery (pubovaginal sling [PVS] = 87, tension-free v...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2008-07, Vol.199 (1), p.76.e1-76.e4
Main Authors: Jeon, Myung-Jae, MD, Jung, Hyun-Joo, MD, Chung, Sue-Min, MD, Kim, Sei-Kwang, MD, Bai, Sang-Wook, MD
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Female
Gynecology. Andrology. Obstetrics
Humans
intrinsic sphincter deficiency
Medical sciences
Middle Aged
Nephrology. Urinary tract diseases
Obstetrics and Gynecology
pubovaginal sling
Retrospective Studies
stress urinary incontinence
Suburethral Slings
tension-free vaginal tape
transobturator tape
Treatment Outcome
Urinary Bladder Diseases - surgery
Urinary Incontinence, Stress - surgery
Urinary system involvement in other diseases. Miscellaneous
Urinary tract. Prostate gland
Urologic Surgical Procedures
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Summary:Objective The aim of this study was to compare the treatment outcome of 3 sling procedures for stress urinary incontinence with intrinsic sphincter deficiency. Study Design This retrospective study included 253 patients who underwent incontinence surgery (pubovaginal sling [PVS] = 87, tension-free vaginal tape [TVT] = 94, and transobturator tape [TOT] = 72) for urodynamic stress incontinence with intrinsic sphincter deficiency. Analysis of variance, χ2 test, Fisher's exact test, Kaplan–Meier survival analysis, and Cox proportional hazard regression were used for statistical analysis. Results Overall complication rates were not significantly different. At 2 years postoperatively, the cumulative cure rates of the PVS, TVT, and TOT groups were significantly different (87.25%, 86.94%, and 34.89%, respectively; P < .0001). The risk of treatment failure in women who received TOT was 4.6 times higher than in women who underwent PVS. The 7-year cumulative cure rates of PVS and TVT groups were 59.10% and 55.09%, respectively. Conclusion PVS and TVT were more efficacious, but the long-term cure rates were low.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2007.11.060