Efficacy of Tension-Free Vaginal Tape versus Trans-Obturator Transvaginal Tape in the Treatment of Female Stress Urinary Incontinence: A Meta-Analysis.

BACKGROUND

This study aimed to evaluate the mid- to long-term efficacy of tension-free vaginal tape (TVT) and trans-obturator transvaginal tape (TVT-O) by using evidence-based medicine meta-analysis methods to provide a reference for choosing a sling to treat female stress urinary incontinence (SUI).

METHODS

A computer search was performed on PubMed, Embase, Web of Science, ProQuest PsycINFO, CINAHL and Cochrane Library for randomised controlled trials on TVT and TVT-O in the treatment of female SUI. The search time limit was from the establishment of the database to March 2024, and the literature was screened and quality assessed. Meta-analysis was used to appraise the subjective cure rate, objective cure rate and postoperative complication rates and intraoperative of the two surgical methods for SUI.

RESULTS

All 13 included studies were of high quality. The subjective cure rate (Risk Ratio (RR) [1.00] and 95% CI [0.96; 1.05]) and objective cure rate (RR [1.03] and 95% CI [1.00; 1.06]) of TVT and TVT-O were similar. The incidence of hematoma during TVT surgery was significantly higher than that of TVT-O (RR [2.62] and 95% CI [0.84; 8.13]), and the incidence of medial thigh/groin pain after TVT was lower than that of TVT-O (RR [0.25] and 95% CI [0.13; 0.49]). Minimal differences were observed in the incidence of bladder perforation, band erosion and dysuria/urinary retention.

CONCLUSIONS

The mid- and long-term effects of TVT and TVT-O surgical methods in the treatment of female SUI were similar and effective. In terms of complications, TVT had a higher incidence of hematoma than TVT-O, and TVT had a lower incidence of pain in the inner thigh/groin area than TVT-O.