A prospective randomized trial comparing tension-free vaginal tape versus transobturator tape in patients with stress or mixed urinary incontinence: subjective cure rate and satisfaction in median follow-up of 46 months

Objective: The aim of this study was to investigate the difference in subjective cure rate and patient satisfaction between tension-free vaginal tape (TVT) and transobturator tape (TOT) surgical methods in the treatment of stress and mixed urinary incontinence.

Material and methods: From January 2004 to November 2006, a total of 100 patients suffering from stress or mixed urinary incontinence and evaluated to benefit from operative treatment were randomized to undergo either TVT or TOT surgery in Oulu University Hospital. There were no significant differences between the study groups concerning the patient characteristics. During the 3, 14 and 46 month follow-up steps, information on subjective cure and patient satisfaction was gathered with Urinary Incontinence Severity Score and Detrusor Instability Score questionnaires and a specific question about satisfaction.

Results: The subjective cure rate was 81% in both study groups. The satisfaction rate was 79% in the TVT group and 74% in the TOT group at the final follow-up. Urge symptoms were relieved in 70% of patients in the mixed urinary incontinence subgroup. De novo urgency occurred in 17% of the patients in the stress urinary incontinence subgroup, and 45% of these patients were unsatisfied after the follow-up.

Conclusions: TVT and TOT are equally effective methods in the treatment of urinary incontinence and patient satisfaction is similar in both methods. A large proportion of patients with mixed urinary incontinence found the operation beneficial for urge symptoms.