Department of Obstetrics and Gynecology, University of Ulm, DE-89075 Ulm, Germany.
Gynecol Obstet Invest. 2009;68(2):137-44. doi: 10.1159/000229502. Epub 2009 Jul 24.
To compare the results and ultrasonographic characteristics of the transobturator vaginal tape (TVT-O) and retropubic (TVT) methods.
120 patients were treated with TVT-O. These were paired with similar patients treated with TVT. The patients were matched according to age, low-pressure urethra, preexisting mixed incontinence, and additional prolapse repair. The follow-up time was 3 months. Assessment variables included a standardized questionnaire, medical history, voiding diary, urinary stress test, 24-hour pad test, and introital ultrasound. The position of the tape was defined by its location in relation to urethral length (%) and the narrowness by its distance to the hypoechoic center of the urethra (mm).
The rates of postoperative complications including bladder perforation, urinary retention, and erosion through the vagina were similar. The number of hematomas occurring after TVT was insignificantly higher than after TVT-O (5 cases vs. 1 case). The rates for cure or improvement of stress incontinence were 77 and 17% after TVT-O and 85 and 14% after TVT (not significant). The sonographic characteristics were identical.
In terms of clinical outcome, TVT and TVT-O appear to be equally effective. Complications and sonographic characteristics of the tapes were similar after both procedures.
比较经闭孔阴道吊带术（TVT-O）和耻骨后（TVT）方法的结果和超声特征。
120 例患者接受 TVT-O 治疗。这些患者与接受 TVT 治疗的类似患者相匹配。根据年龄、低压尿道、先前存在的混合性尿失禁和额外的脱垂修复情况对患者进行匹配。随访时间为 3 个月。评估变量包括标准化问卷、病史、排尿日记、尿失禁压力测试、24 小时垫试验和阴道入口超声。吊带的位置通过其相对于尿道长度的位置（%）和其与尿道低回声中心的距离（mm）来定义。
包括膀胱穿孔、尿潴留和阴道侵蚀在内的术后并发症发生率相似。TVT 后血肿的发生率明显高于 TVT-O（5 例比 1 例）。TVT-O 治疗后压力性尿失禁的治愈率或改善率为 77%和 17%，而 TVT 治疗后为 85%和 14%（无显著差异）。超声特征相同。
在临床疗效方面，TVT 和 TVT-O 似乎同样有效。两种手术的并发症和吊带的超声特征相似。
