Geburtshilfe Frauenheilkd 2014; 74 - A16
DOI: 10.1055/s-0034-1374751

Retropubic (TVT) versus transobturator (TVT-O) tension-free vaginal tape: five-year results of the Austrian randomized trial

T Aigmueller 1, A Tammaa 2, E Hanzal 3, W Umek 4, S Kropshofer 5, P Lang 6, G Ralph 7, P Riss 8, D Koelle 9, K Jundt 10, K Tamussino 11, V Bjelic-Radisic 12
  • 1Medical University of Graz, Department of Gynecology; Graz, Austria
  • 2Wilhelminenspital Wien, Department of Obstetrics and Gynecology; Vienna, Austria
  • 3Medical University of Vienna, Department of Gynecology, Vienna, Austria
  • 4Medical University of Vienna, Department of Gynecology, Vienna, Austria
  • 5Medical University of Innsbruck, Department of Gynecology; Innsbruck, Austria
  • 6Krankenhaus der Bermherzigen Brueder Graz, Department of Gynecology; Graz, Austria
  • 7Landeskrankenhaus Leoben, Department of Obstetrics and Gynecolgoy; Leoben, Austria
  • 8Landesklinikum Moedling, Department of Obstetrics and Gynecology; Moedling, Austria
  • 9Krankenhaus Schwaz, Department of Obstetrics and Gynecology; Schwaz, Austria
  • 10Medical University of Munich, Department of Obstetrics and Gynecology; Munich, Germany
  • 11Medical University of Graz, Department of Gynecology; Graz, Austria
  • 12Medical University of Graz, Department of Gynecology; Graz, Austria, Austrian Urogynecology Working Group

Objective: Five year results of a randomized controlled trial comparing objective and subjective outcomes of TVT with those of TVT-O as primary treatment for stress urinary incontinence. Methods: Prospective, randomized controlled trial at 25 centers in Austria and Germany (ClinicalTrials.gov NCT 00441454). Clinical, urodynamic and quality of life assessment was performed preoperatively and 5 years after surgery. Statistical analysis: intention to treat, per protocol; chi-square test, t-test, Fisher's exact test, ANOVA. Results:

A total of 569 women were randomized to retropubic or transobturator TVT and 331 patients (60%) were examined at 5 years. No statistical significant differences were seen in negative cough stress (83% vs. 76%, respectively), complications and urodynamic parameters. Quality-of-life parameters improved significantly in both groups, without significant differences between groups. Reoperation rates were 6.1% and 3.2%, erosion rates were 5.2% and 4.1%, respectively. Conclusion: Although the study did not meet its follow-up goal, the long-term results of this randomized trial indicate satisfactory and stable long-term results and improved Quality of Life with both the retropubic and the transobturator TVT. Major long-term problems appear rare.