Comparative Outcomes of Transobturator Tape and Tension-Free Vaginal Tape Procedures in Mixed Urinary Incontinence: A Retrospective Cohort Study

Aim: This study aimed to compare the outcomes of Transobturator Tape (TOT) and Tension-Free Vaginal Tape (TVT) procedures in the treatment of Mixed Urinary Incontinence (MUI), focusing on objective and subjective cure rates, postoperative complications, and quality of life improvements. Materials and Methods: A retrospective cohort study was conducted at a tertiary hospital specializing in women's health and education between January 2014 and June 2018. Seventy patients diagnosed with MUI underwent either TOT (n=38) or TVT (n=32) procedures. Preoperative and postoperative data were collected, including demographics, urodynamic parameters, and validated quality of life questionnaires (UDI-6 and IIQ-7). Objective cure was defined as a negative cough stress test and no need for incontinence medication. Subjective cure was determined by UDI-6 scores. Statistical analysis was performed to evaluate outcomes and identify factors affecting surgical success. Results: Both TOT and TVT procedures significantly improved quality of life, with no significant difference in objective cure rates (68.4% vs. 65.6%, p=0.804) or postoperative complications between the two groups. Urethral mobility was identified as a positive predictor of objective cure (OR 1.1, p=0.020), while detrusor overactivity negatively impacted surgical success (OR 1.1, p=0.031). Both procedures demonstrated similar efficacy in treating the stress and urge components of MUI. Conclusions: TOT and TVT are equally effective and safe for the short-term treatment of MUI, with low complication rates. Urethral mobility and detrusor overactivity are important factors influencing surgical outcomes. Further large-scale, prospective studies are needed to confirm these findings and optimize patient selection for these procedures.