Retropubic versus Transobturator TVT: Five-Year Results of the Austrian Trial

The Austrian Urogynecology Working Group (AUB) conducted a randomized trial to compare retropubic vs. transobturator tension-free vaginal tape (TVT vs. TVT-O; ClinicalTrials.gov NCT 00441454). We present the results at 5 years. A total of 565 women scheduled for surgical treatment of stress incontinence were randomized to undergo retropubic or transobturator placement of a TVT (Gynecare, Ethicon). All patients had preoperative and were scheduled for postoperative clinical, urodynamic and quality-of-life assessments. Three hundred two (53%) of the 565 operated patients were seen at 5 years. A negative cough stress test was seen in 83% of patients after TVT and 76% of patients after TVT-O. No pad use was reported by 56% of patients after TVT and 58% of patients after TVT-O. None of these differences reached statistical significance. One tape exposure was noted after TVT and 3 after TVT-O. There were 9 (6%) reoperations after TVT and 5 (3%) after TVT-O. Although the study did not meet its follow-up goal at 5 years, results 5 years after TVT and TVT-O appear to be stable and similar. Major long-term problems appear rare.