Transobturator Tape Offers Tx Option for Stress Urinary Incontinence


MONTREAL — Clinicians looking for a less invasive treatment for stress urinary incontinence can choose transobturator tape instead of tension-free vaginal tape, according to Italian researchers.

“The results [efficacy] are equal and the complications are very similar,” said Ervin Kocjancic, M.D., a urology specialist at the University of Piemonte Orientale in Novara, Italy.

“This is a very important study because, until now, we had very little research comparing these methods,” he said in an interview.

Dr. Kocjancic was one of the investigators in a multicenter trial that randomized 96 women with stress or mixed urinary incontinence to treatment with either tension-free vaginal tape (TVT) or transobturator tape (TOT).

All women had stress or mixed urinary incontinence with urethral hypermobility and a positive Bonney test, coinvestigator Elisabetta Costantini, M.D., reported at the annual meeting of the International Continence Society.

Follow-up included clinical check-ups at 3, 6, 9, and 12 months; symptom questionnaires (the Urogenital Distress Inventory, or UDI-6, and the Incontinence Impact Questionnaire, or IIQ-7); and free flowmetry with postmicturitional residue evaluation.

Intraoperative and postoperative complications (early and late) were recorded, as were treatment efficacy (subjective and objective) and any new-onset urinary disturbances, said Dr. Costantini, of the University of Perugia (Italy).

There were no significant differences between groups in complications or outcome. However, there was a trend toward slightly worse outcome in TVT patients with mixed incontinence in that they experienced more new cases of urgency disturbances after surgery, compared with the TOT patients, said Dr. Kocjancic.

“Mixed incontinence patients are the most complicated group of patients, and they did better with TOT,” he said.

Roughly 2% of the TOT group reported new-onset storage symptoms following surgery, compared with roughly 10% of the TVT group, but this difference was not significant.

Among those with mixed incontinence, however, storage symptoms were significantly improved in the TOT group—with 85% reporting an improvement in urgency, compared with 19% in the TVT group.

Roughly 2% of the TOT group reported new-onset storage symptoms following surgery, compared with roughly 10% of the TVT group.

The study is ongoing, and the results require confirmation with more patients and longer follow-up, Dr. Costantini concluded.

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