Clinical efficacy of tension-free vaginal tape-ischiopubic ramus versus transobturator tension-free vaginal tape in the management of female stress urinary incontinence

Abstract

BACKGROUND: Stress urinary incontinence (SUI), a prevalent condition among middle-aged and elderly women in China, is characterized by the involuntary leakage of urine during instances of increased abdominal pressure [1]. Although SUI is not life-threatening, it substantially impacts patients’ physical and psychological well-being, impairs their social interactions, and diminishes their overall quality of life. OBJECTIVE: The aim of this study was to evaluate and compare the clinical efficacy of tension-free vaginal tape-ischiopubic ramus (TVT-IR) and transobturator tension-free vaginal tape (TVT-O) in the treatment of female stress urinary incontinence (SUI). METHODS: A retrospective analysis of clinical data from 83 female SUI patients was conducted, dividing them into a TVT-IR group (n= 41) and a TVT-O group (n= 42) based on the surgical procedures employed. Perioperative indices, surgical efficacy, complications, symptom improvement pre- and post-operation (3 months), urodynamic measurements, and indices related to pelvic floor function and quality of life were compared between the two groups. RESULTS: The TVT-IR group had significantly shorter operative time than the TVT-O group (P< 0.05). Three months after surgery, both groups had significantly lower frequency of incontinence, incontinence score, and number of nocturnal urination, significantly higher Pdet, ALPP, Qmax, and MUCP, significantly higher class I and class II fiber muscle strength and muscle potential, and significantly higher I-QOL scores (P< 0.05). The aforementioned indicators were superior in the TVT-IR group compared to the TVT-O group three months after surgery (P< 0.05). CONCLUSION: Both TVT-IR and TVT-O are effective in treating SUI, with comparable complication rates.