Surgical management of stress urinary incontinence in women: safety, effectiveness and cost-utility of trans-obturator tape (TOT) versus tension-free vaginal tape (TVT) five years after a randomized surgical trial
2011

Comparing Two Surgical Procedures for Stress Urinary Incontinence in Women

Sample size: 199 publication 10 minutes Evidence: moderate

Author Information

Author(s): Ross Sue, Robert Magali, Lier Doug, Eliasziw Misha, Jacobs Philip

Primary Institution: University of Calgary

Hypothesis

What is the incidence of vaginal erosion or other serious adverse outcomes of surgery among women who had a surgical procedure for stress urinary incontinence utilizing a TOT device, versus a TVT device, over the 5 years following surgery?

Conclusion

The study suggests that while the TOT procedure may be more cost-effective than TVT, there are concerns about the long-term safety and effectiveness of the TOT approach.

Supporting Evidence

  • 199 women participated in the original trial, with 94 in the TOT group and 105 in the TVT group.
  • At 12 months, 81% of women in the TOT group were cured compared to 77% in the TVT group.
  • 80% of women in the TOT group had palpable tape compared to 27% in the TVT group.
  • Quality of life improved significantly in both groups after surgery.

Takeaway

This study looks at two types of surgery for women who leak urine when they laugh or cough, to see which one is safer and better over five years.

Methodology

The study will follow up with all 199 women from the original trial, assessing vaginal erosion, urinary incontinence, and quality of life through physical exams and questionnaires.

Potential Biases

Potential bias due to non-blinded outcome assessments and the nature of patient follow-up.

Limitations

The study may have a 20% loss to follow-up and relies on self-reported data for some outcomes.

Participant Demographics

All participants were women with stress urinary incontinence, aged 60 years or younger.

Statistical Information

P-Value

0.58

Confidence Interval

95%CI 0.90 to 1.23

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1186/1472-6874-11-34

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