**2.2.1 TVT surgical outcomes**

TVT has undergone the most rigorous testing all over the years, and now it is considered the gold standard treatment option for female SUI. To date it is estimated that more than 1 million cases have been performed worldwide **(Deng et al, 2007)**. There are now many prospective studies in literature with a long-term follow-up showing great success of TVT for the treatment of female SUI with cure rate > 80 % as seen in (table 2) denoting the long term durability of this procedure. In 2008, Nilsson et al reported the longest follow-up (11 years) of TVT operation and demonstrated that (90% objective cure rate) of women treated without any significant late-onset adverse effects **(Nilsson et al, 2008)**. In another study with follow-up for 10 years. TVT showed satisfactory objective (84%) and subjective (57%) cure rates with (23%) improvement **(Aigmueller et al, 2011)**.


Table 2. Long term results of TVT.

TVT has replaced the old gold standard Burch colposuspension. In a randomized control trial (RCT) conducted by Ward and Hilton who compared TVT with the open colposuspension on they reported equal efficacy with subjective cure rate 81% and 80% in TVT and Burch group respectively. The duration of hospitalization, operative time and the time taken to return to normal activity seem to be shorter in the TVT group. The authors concluded that the TVT procedure is as effective as the Burch colposuspension in urodynamically proven patients with SUI at a 2-year follow-up **(Ward and Hilton, 2004)**. The same authors have published their 5-year out comes in this study where they reported subjective cure in 81% in the TVT group and 90% in the colposuspension group. They stated that the effect of both procedures on cure and improvement in quality of life has been maintained for long time **(Ward and Hilton, 2008)**.

#### **2.2.2 TOT surgical outcomes**

Short-term data regarding the efficacy of the TOT suggest that this procedure perform as well as the TVT and may perhaps cause fewer complications. TOT has shown to be of equal


efficacy to TVT with cure rate > 80% (table 3), however, still long-term studies have yet to be done to evaluate the effectiveness and durability of the TOT procedure.

Table 3. Results of TOT.

294 Urinary Incontinence

TVT has undergone the most rigorous testing all over the years, and now it is considered the gold standard treatment option for female SUI. To date it is estimated that more than 1 million cases have been performed worldwide **(Deng et al, 2007)**. There are now many prospective studies in literature with a long-term follow-up showing great success of TVT for the treatment of female SUI with cure rate > 80 % as seen in (table 2) denoting the long term durability of this procedure. In 2008, Nilsson et al reported the longest follow-up (11 years) of TVT operation and demonstrated that (90% objective cure rate) of women treated without any significant late-onset adverse effects **(Nilsson et al, 2008)**. In another study with follow-up for 10 years. TVT showed satisfactory objective (84%) and subjective (57%) cure

**Patient group Duration of** 

34 Recurrent SUI 4 82%

51 SUI 6.9 80%

90 SUI 7 81.3%

**Villet et al, 2002** 124 SUI 32.5 months 88.7%

incontinence

(ISD)

TVT has replaced the old gold standard Burch colposuspension. In a randomized control trial (RCT) conducted by Ward and Hilton who compared TVT with the open colposuspension on they reported equal efficacy with subjective cure rate 81% and 80% in TVT and Burch group respectively. The duration of hospitalization, operative time and the time taken to return to normal activity seem to be shorter in the TVT group. The authors concluded that the TVT procedure is as effective as the Burch colposuspension in urodynamically proven patients with SUI at a 2-year follow-up **(Ward and Hilton, 2004)**. The same authors have published their 5-year out comes in this study where they reported subjective cure in 81% in the TVT group and 90% in the colposuspension group. They stated that the effect of both procedures on cure and improvement in quality of life has been

Short-term data regarding the efficacy of the TOT suggest that this procedure perform as well as the TVT and may perhaps cause fewer complications. TOT has shown to be of equal

80 Mixed urinary

49 SUI due to

**follow-up (years)** 

**Treatment outcomes (subjective/objective) % cured** 

4 85%

4 74%

**2.2 Clinical results of midurethral slings** 

rates with (23%) improvement **(Aigmueller et al, 2011)**.

**patients** 

**Author Number of** 

**Rezapour et al, 2001a** 

**Rezapour et al, 2001b** 

**Rezapour et al, 2001c** 

**Deffieux et al, 2007** 

**Nilsson et al, 2004** 

Table 2. Long term results of TVT.

**2.2.2 TOT surgical outcomes** 

maintained for long time **(Ward and Hilton, 2008)**.

**2.2.1 TVT surgical outcomes** 
