Modified prepubic TVT-obturator tape procedure versus the conventional method: a preliminary study

Area of Science:

• Urology
• Gynecology
• Surgical Innovation

Background:

• Female stress urinary incontinence (SUI) significantly impacts quality of life.
• Tension-free vaginal tape-obturator (TVT-O) is a common surgical treatment for SUI.
• Modifications to surgical techniques aim to improve efficacy and patient outcomes.

Purpose of the Study:

• To compare the efficacy and safety of a modified prepubic tension-free vaginal tape-obturator (PTVT-O) procedure against the original TVT-O method.
• To evaluate surgical outcomes, including cure rates, complication rates, and patient-reported symptoms.

Main Methods:

• A comparative study involving 190 women with urodynamic stress incontinence (USI).
• Participants were divided into two groups: original TVT-O (93 women) and modified PTVT-O (97 women).
• Clinical assessments included urinalysis, 1-hour pad tests, urodynamic studies, and the Overactive Bladder Symptom Score (OABSS) questionnaire before and one year after surgery.

Main Results:

• The PTVT-O group showed significantly higher surgical efficacy (cure and improvement) compared to the TVT-O group (P=0.038).
• No significant differences were observed in mean age, parity, menopausal status, operative time, subjective cure rates, complication rates, or visual analog scale (VAS) pain scores between the groups.
• Overactive Bladder Symptom Score (OABSS) decreased significantly in both groups post-surgery, with no significant differences in urodynamic parameters.

Conclusions:

• The modified PTVT-O procedure is a safe and effective treatment for female USI.
• PTVT-O offers an advantage over the original TVT-O with improved surgical efficacy and comparable postoperative pain.
• Further studies with longer follow-up periods are warranted to fully elucidate long-term outcomes.