Comparison of Transobturator Tape and Pubovaginal Sling Techniques for Stress Urinary Incontinence

Aim: Mesh-assisted inside-out transobturator tape (TOT) and pubovaginal sling (PVS) using autologous fascia (AF) are surgical options for female stress urinary incontinence (SUI). In this study, the aim was to compare two techniques, determine objective and subjective cure rates, and show results with perineal ultrasound (PU). Methods: We analyzed 96 patients with isolated SUI and recorded the postoperative results after 2 years of follow-up. Objective cure was defined as the absence of SUI findings in the cough-stress test and Q-type test. Subjective cure was defined as the patient’s evaluation according to the International Consultation on Incontinence Questionnaire Short Form questionnaire. PU measurements supported postoperative results, with mesh-related complications requiring reoperation. Results: The cure rate was 97.9% for patients who underwent inside-out TOT with mesh and 87.5% for those who underwent PVS with AF, according to the results of the standing and lying stress test. Meanwhile, the cure rates were 97.9% and 83.3%, respectively, according to the Q-type test. After the operation, only one patient (2.1%) in the group who received inside-out TOT with mesh in standing and lying stress test showed new onset of overactive bladder. Six patients (12.5%) in the group who received PVS with AF showed the same finding. Postoperatively, Q-type test rates were 2.1% and 16.7% in one and eight patients, respectively. Mesh erosion was found in 2.1% of patients who had undergone inside-out TOT with mesh. A PU indicated a significant improvement in the cystocele descent. Conclusions: PVS surgery with AF and inside-out TOT surgery with mesh can be used with satisfactory efficacy for SUI. PU can predict the success of surgical interventions for SUI.