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  • Title: Transobturator vs single-incision suburethral mini-slings for treatment of female stress urinary incontinence: early postoperative pain and 3-year follow-up.
    Author: Neuman M, Sosnovski V, Kais M, Ophir E, Bornstein J.
    Journal: J Minim Invasive Gynecol; 2011; 18(6):769-73. PubMed ID: 22024263.
    Abstract:
    STUDY OBJECTIVE: To compare related pain and cure using the transobturator and single-incision suburethral mini-sling anti-incontinence operations. DESIGN: Open, prospective, nonrandomized 2-armed study comparing 2 surgical procedures for treatment of female stress urinary incontinence (Canadian Task Force classification II-1). SETTING: A university and a private hospital. PATIENTS: One hundred sixty-two women with stress urinary incontinence underwent either a tension-free vaginal tape-obturator (TVT-O) or a single-incision (TVT-SECUR) suburethral or mid-urethral tape operation. MEASUREMENTS AND MAIN RESULTS: Pain levels were estimated using a visual analog scale, and outcome using the Urinary Distress Inventory and the Incontinence Impact Questionnaire. Postoperative vaginal and thigh pain was transient, lasting for up to 2 weeks, and occurred significantly more frequently in the TVT-O group (32% vs 1% and 32% vs 0%, respectively). Dyspareunia was not self-limited, and occurred more frequently in the TVT-SECUR group (7.9% vs 0%). Cure rates were 86.9% in the TVT-O group and 90.9% in the TVT-SECUR group. Complication rates were similar in the 2 groups. CONCLUSION: Both procedures were effective, with few adverse effects. In sexually inactive patients, the TVT-SECUR procedure may be preferable because thigh and vaginal pain is largely averted with this procedure. Sexually active patients might be better referred for the TVT-O procedure because it was not followed by dyspareunia in our series. Patient choice of surgical method rather than randomization weakened the strength of this study.
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