Resumo

MORA HERVAS, Irene; AMAT TARDIU, Lluís; MARTINEZ FRANCO, Eva  e  LAILLA VICENS, Josep María. Analysis of the efficacy and complications of the surgical treatment of stress urinary incontinence: retropubic and transobturator TVT^TM. Our experience. Arch. Esp. Urol. [online]. 2007, vol.60, n.9, pp.1091-1098. ISSN 0004-0614.

Objectives: To evaluate the differences in results and complications between retropubic and obturator TVT. Methods: Descriptive prospective study including 245 patients who underwent retropubic TVT and 90 obturator TVT, after the diagnosis of stress urinary incontinence by means of clinical history, physical examination and urodynamic tests. Continence outcomes and Intraoperative/post operative complications were recorded. Results: There were intraoperative complications in 12.65% of the retropubic TVT and 1.11% of the obturator TVT (p = 0.002). Immediate post operative complications appeared in 24.5% of the retropubic TVTs and 12 .2% of the obturator TVTs: severe anemia (0.4 vs. 1.1%), inguinal pain (1.2 vs. 4.4%), hematoma (1.6 vs. 0%), urinary tract infection (12.2 vs. 4.4%), and acute urinary retention (8.9 vs. 2.2%) (p = 0.018). Complications during follow-up: partial exteriorization of the mesh (0.81 vs. 1.11%) and de novo urgency incontinence (9.38 vs. 4.44%) (p = 0.031). Post operative results were similar for both groups: 90.2% vs. 91.1% cured (p = 0.046), improvement in 8.2% vs. 6.7% (p = 0.18) and failure in 1.6% vs. 2.2% (p = 0.57). Conclusions: The obturator TVT seems to be preferable to retropubic TVT because it offers a lower complications rate without differences in post operative results in the short-term.

Palavras-chave : Stress urinary incontinence; Tensions free vaginal tapes; Retropubic approach; Transobturator approach; Complications; Results.

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