What are the long-term outcomes of TOT and TVT procedures?
Reviewed by Ann Crump

This is a systematic review between 2000 and 2016 evaluating the efficacy and safety of midurethral sling (MUS) procedures in women. Studies were included if the follow-up data was five years or more. Objective cure rates showed no significant difference between tension-free vaginal tape (TVT) or transobturator tape (TOT) procedures (either if TOT-OI or TOT-O). Objective cure rates after at least five years of follow-up ranged from 61-67%. Subjective cure rates also showed no significant difference between the two groups (approximately 68%). Complication rates between the different approaches also showed no significant difference (0.17-3.46%). The main limitation of the study is that there are not large numbers of papers to review with long-term data so prospective and retrospective studies were included, as well as randomised controlled trials. Nevertheless, it is an interesting paper suggesting that prediction of success whatever the approach success is difficult based on current evidence. – AC

Long-term outcomes of TOT and TVT procedures for the treatment of female stress urinary incontinence: a systematic review and meta-analysis. Maggiore ULR, Agro EF, Soligo M, et al.
INTERNATIONAL UROGYNECOLOGY JOURNAL
2017;28:1119-30.