A prospective observational cohort study comparing perioperative outcomes, complications, and quality of life between surgical procedures for female stress urinary incontinence.

Abstract

Objective: To compare perioperative outcomes, complications, and quality of life between tension-free vaginal tape obturator (TVT-O) and retropubic tension-free vaginal tape exact (TVT-E) procedures for female severe stress urinary incontinence (SUI).

Methods: This prospective cohort study enrolled women undergoing surgery for severe stress urinary incontinence (December 2023-February 2025). Patients were grouped by procedure (TVT-O vs. TVT-E). We compared perioperative data, complications, quality-of-life scores (ICI-Q-SF, IIQ-7, PISQ-12 at 6 and 12 months), and 12-month objective cure rates. Kaplan-Meier curves assessed cumulative recurrence.

Results: Of 120 patients enrolled (TVT-O: 66; TVT-E: 54), baseline characteristics were comparable (P > 0.05). Operative time was significantly shorter in the TVT-O group (P < 0.001), with no significant differences in blood loss, catheterization time, or hospital stay. Complication rates were similar (TVT-O: 21.21% vs. TVT-E: 18.52%, P = 0.710), including specific complications like groin pain. Both groups showed significant postoperative quality-of-life improvements (P < 0.001), but between-group differences were not significant. At 12 months, objective cure rates and cumulative recurrence-free survival were comparable between groups.

Conclusion: Both TVT-O and TVT-E are safe and effective for severe SUI, significantly improving quality of life. TVT-O offers shorter operative time with equivalent efficacy and complication rates to TVT-E.