Transobturator Tape (TOT) and Suprapubic Arc (SPARC) in Women with Stress Urinary Incontinence: A Comparison between Two Minimally Invasive Treatments

Abstract

Background: Stress urinary incontinence (SUI) is very prevalent in middle-aged women. Minimal invasive anti-incontinence surgery is the most common surgery for treating the problem. The purpose of this study was to compare the therapeutic results and complications of minimally invasive anti-incontinence operative procedures for middle-aged women with SUI. Methods: We prospectively evaluated 146 women with SUI, who underwent suprapubic arc (SPARC) or transobturator (TOT) sling by the same surgeon. Findings: Concurrent anterior prolepses repair was performed in 43 (59.7%) and 29 (39.2%) patients in the SPARC and TOT groups, respectively. Objective cure rate was 90% and 93% respectively in the SPARC and TOT groups. Voiding difficulties were observed in 8 (11.1%) cases of the SPARC group and 13 (17.6%) patients of the TOT group. Urethrolysis and complete mesh removal were necessitated in 2 cases of the SPARC group. Regional and pelvic pains were observed in 3 (4.2%) and 10 (13.5%) patients of the SPARC and TOT groups, respectively. Vaginal erosion occurred in 8 (11.1%) and zero individuals of the SPARC and TOT groups, respectively Conclusion: The short-term anti-incontinence effects of SPARC and TOT were much similar. However, chronic pelvic and groin pain (with movement) occurred in 13.5% of women in the TOT group which implies the need for further study to determine the best technique in active women.

Keywords

• Stress urinary incontinence
• Trans vaginal sling
• Transobturator sling