A comparative study of outside-in and inside-out transobturator tape procedures for stress urinary incontinence

Aims: This study compared the clinical outcome of patients undergoing outside-in transobturator tape (TOT) or inside-out transobturator tape (TVT-O) procedures for female stress urinary incontinence (SUI).

Methods: The study examined the medical records of 615 patients who underwent TOT (376 patients) or TVT-O (239 patients) for SUI, and compared patient characteristics, operation time, duration of hospital stay, cure rates, and complication rates, by conducting a 1-year follow-up survey.

Results: The TOT and TVT-O groups were found to be similar in terms of operation time, duration of hospital stay, surgical outcome (both before and after adjustment for age, parity, menopause, and previous pelvic surgery, cure rate (87.8% for TOT and 85.3% for TVT-O) and complication rate (14.4% for TOT, 15.5% for TVT-O). The complication rates after operations did not differ significantly between the two groups. Complications over the 1-year follow-up included urinary retention, de novo urgency, leg pain, vaginal mesh erosion, and hematoma, and all resolved following appropriate treatment.

Conclusions: The TOT and TVT-O procedures appeared to be equally clinically effective and safe when used to treat female SUI.