Comparison of Long-Term Efficacy and Reliability of Mid-Urethral Sling Surgeries in Stress Type Urinary Incontinence Treatment

Abstract

Aim: Trans-obturator tape (TOT) and tension free vaginal tape (TVT) operations are standard mid urethral sling surgeries used in stress type urinary incontinence (STUI) treatment. We aimed to evaluate the clinical success, complications and long-term efficacy / reliability of TOT / TVT surgeries.Materials and Methods: A total of 79 patients who underwent middle urethral sling (TOT and TVT) operation by a single surgeon under spinal anesthesia between 2011-2020 were evaluated retrospectively. Pre-operative anamnesis, physical examination, laboratory evaluation and urodynamic examinations of the patients were analysed. Surgical success, per-operative complications, post-operative early and late complications were evaluated.Results: Trans-obturator tape and TVT surgery was performed in 41 (51.9%) and 38 (48.1%) patients respectively. The average age of the patients was 54.5 ± 9.5 years and the mean follow-up period was 55.4 (min 2.9-max 113.7) months. It was observed that STUI symptoms disappeared completely in 77 patients (97.5%) after surgery, while STUI symptoms continued in 2 (2.5%) patients with TVT. De-novo urgency incontinence was observed in 4 (5%) TVT patients and 5 (6.3%) TOT patients at post-operative period.Conclusion: Mid-urethral sling operations (TOT and TVT surgeries) are the treatment options with high success rates in STUI treatment. Although complication rates were higher in TVT operation compared to TOT surgery, after long-term follow-up, it was found that both operations were effective and reliable.

Keywords

• mid-urehtral sling surgery
• trans-obturator tape (tot)
• tension free vaginal tape (tvt)
• stress type urinary incontinence