A Comparative Study of Outside-In and Inside-Out Transobturator Tape Procedures for Female Stress Urinary Incontinence: 7-Year Outcomes

作者：Chun Ji Youn; Song Miho; Yoo Dae Seon; Han Ji Yeon; Hong Bumsik; Choo Myung Soo^*

来源：Lower Urinary Tract Symptoms, 2014, 6(3): 145-150.

DOI：10.1111/luts.12052

• comparative study
• stress urinary incontinence
• transobtulator sling

ObjectivesThe aim of this study was to compare the long-term surgical outcomes of the inside-out (TVT-O) and outside-in (TOT) transobturator tape procedures for treating female stress urinary incontinence (SUI). %26lt;br%26gt;MethodsThis was a retrospective analysis of women who underwent a transobturator tape procedure and were followed for at least 7years. Patients%26apos; baseline characteristics and urodynamic parameters were compared between the two groups and analyzed to identify factors related to failure of therapy. %26lt;br%26gt;ResultsA total of 215 patients were followed for%26gt;7years (TOT, n=129; TVT-O, n=86), with a median follow-up period of 7.1years. No significant differences were observed in the baseline characteristics or urodynamic parameters between the groups, except incontinence type (TOT 33.3% vs. TVT-O 52.3% with mixed urinary incontinence, P%26lt;0.05). The TOT group had significantly higher cure rate, satisfaction with surgery, willingness to undergo the procedure to others, and willingness to receive the same procedure than those of the TVT-O group (87.1 vs. 66.7%, 87.6 vs. 64.0%, 89.1 vs. 77.9%, and 77.5 vs. 57.0%, all P-values%26lt;0.05), respectively. A Univariate analysis identified maximum urethral closure pressure (MUCP) (odds ratio, 0.980; 95% confidence interval, 0.960-1.000; P=0.046) as a risk factor for surgical failure. %26lt;br%26gt;ConclusionsTOT and TVT-O procedures are safe and effective for the treatment of SUI in women over a 7-year follow-up period. The TOT procedure had higher cure rate and satisfaction rates than TVT-O. MUCP may be associated with surgical outcome.

• 出版日期2014-9