The outside-in and inside-out approaches to transobturator tension-free vaginal tape (TO-TVT) surgery are associated with similar five-year outcomes, according to researchers.

Rachel Yau Kar Cheung, MB, and colleagues at The Chinese University of Hong Kong, prospectively studied 213 women who underwent TO-TVT surgery for stress urinary incontinence. Surgeons used the outside-in approach (TOT) in 124 cases and the inside-out approach (TVT-O) in 89 cases.

After a mean follow-up of 59.2 months, the TOT and TVT-O groups had an objective cure rate of 82.6% and 82.5%, respectively, and a subjective cure rate of 81.7% and 84.1%, respectively, the investigators reported online in the International Journal of Urology. The TOT and TVT-O arms also were similar with respect to the development of de novo overactive bladder syndrome (10.6% and 14.6%) and de novo detrusor overactivity (5.8% and 15%). In addition, complications at the fifth year were low and did not differ significantly between the groups.

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