TOT for treatment of stress urinary incontinence: how should we assess its equivalence with TVT?

• DOI: 10.1007/s00192-010-1138-9
• Publication Date: 2010-04-27T11:48:29Z
• Authors: Ahmed S. EL-Hefnawy; Bassem S. Wadie; Mohsen El Mekresh; Adel Nabeeh; Mahmoud A. Bazeed
• Keywords: Stress incontinence

Synthetic mid-urethral slings are currently considered the treatment of choice for stress urinary incontinence (SUI). In this study, two types of slings are compared: TVT vs. TOT.In a prospective randomized study, 40 patients underwent either TVT (19 patients) or TOT (21 patients). Stress-specific and overall success was evaluated. Perioperative complications were classified according to Clavien's classification.Mean duration of follow-up was 20 months. At last follow-up, stress-specific success rate was 94.6% in TVT vs. 81% in TOT. No significant difference was detected in terms of post-void residual urine, symptom score, and filling and voiding parameters. Thigh pain represented the main complication in the TOT group.Both TVT and TOT are effective procedures for treatment of SUI. When compared to each other, TOT seems to be inferior to TVT in terms of efficacy, causing less serious complications.