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Outcome and sexual function after transobturator tape procedure versus tension-free vaginal tape SECUR: a randomized controlled trial

Tang, Xiang PhD, MD; Zhu, Lan MD; Liang, Shuo MD; Lang, Jinghe MD

doi: 10.1097/GME.0000000000000119
Original Articles

Objective This study aims to compare efficacy, safety, and sexual function between inside-out transobturator tape (TVT-O) and tension-free vaginal tape SECUR (TVT-S) procedures for stress urinary incontinence (SUI) treatment.

Methods Ninety-four women without concomitant pelvic organ prolapse repairs were randomly allocated to undergo TVT-O or TVT-S procedure. Demographic data, intraoperative and postoperative complications, and surgical outcomes were analyzed. Patients completed the Chinese version of the Incontinence Impact Questionnaire Short Form and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire Short Form (PISQ-12) before surgical operation and on follow-up after surgical operation.

Results There were no significant differences in cure rates between the two groups at 12 and 24 months of follow-up. Hematomas occurred in two patients in the TVT-O group. Urinary retention and de novo urinary urgency were similar in both groups. Operative time was significantly shorter for patients in the TVT-S group (P < 0.05), and postoperative groin/thigh pain was higher (P < 0.05) in the TVT-O group. In both groups, Incontinence Impact Questionnaire Short Form scores improved significantly after surgical operation (P < 0.001). Compared with a mean (SD) score of 33.9 (4.5) postoperatively (12 mo), the total PISQ-12 score before surgical operation was 30.9 (6.5), representing a significant difference (P = 0.021) in the TVT-S group. There was no significant difference in PISQ-12 scores before and after the TVT-O procedure.

Conclusions The two techniques seem to be equally effective for SUI treatment. However, TVT-O results in a higher rate of groin/thigh pain and longer operative time. TVT-S can improve quality of life and sexual function in women with SUI.

From the Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.

Received May 28, 2013; revised and accepted August 29, 2013.

Funding/support: None.

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Lan Zhu, MD, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Dongcheng District, Beijing, China. E-mail:

© 2014 by The North American Menopause Society.