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.