TVT vs TOT: a case controlled study in patients with mixed urodynamic stress incontinence and detrusor overactivity.

Introduction: Although transobturator tapes (TOT) have been suggested to be equivalent to retropubic tension-free vaginal tapes (TVT) in the management of urodynamic stress incontinence, there is very little evidence for their use in women with mixed incontinence. The aim of this study was to evaluate the efficacy of the TOT against the retropubic TVT in women with mixed incontinence.

Patients And Methods: A case controlled study was used with 34 women matched for age and type of procedure.

Results: Ten out of 34 (29.4%) patients in the TOT group required a repeat continence procedure versus 0/34 (0%) in the retropubic group. Patients who had undergone a TOT were significantly more likely to require repeat surgery (odds ratio 10.1, 95% confidence interval 2.6-38.2).

Conclusions: This study suggests a higher failure rate in women undergoing a TOT for USI and DO compared to a retropubic TVT when assessed with a case controlled study.