Open Access Highly Accessed Research article

Efficacy of tension-free vaginal tape compared with transobturator tape in the treatment of stress urinary incontinence in women: analysis of learning curve, perioperative changes of voiding function

Hiroki Ito1*, Hiroyuki Yamanaka1, Masayuki Hagiwara2, Toru Furuuchi2, Kazuhiro Matsumoto2, Kunimitsu Kanai2, Kiichiro Kodaira2, Akiharu Ninomiya2 and So Nakamura2

Author Affiliations

1 Department of Urology, Yokohama City University Graduate School of Medicine and School of Medicine, Yokohama, Japan

2 Department of Urology, Saiseikai Central Hospital, Tokyo, Japan

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BMC Urology 2011, 11:13  doi:10.1186/1471-2490-11-13

Published: 4 July 2011



In this study, by comparing TVT surgery and TOT surgery for stress urinary incontinence in women, the characteristics and learning curves of both operative methods were studied.


A total of 83 women with stress urinary incontinence treated with tension-free vaginal tape (TVT) (n = 38) or transobturator tape (TOT) (n = 45) at Saiseikai Central Hospital between April 2004 and September 2009 were included. We compare the outcomes and learning curves between TVT surgery and TOT surgery. In statistical analysis, Student's t test, Fisher's exact test, and Mann-Whitney's U test were used.


The surgical durations were 37.4 ± 15.7 minutes with TVT surgery and 31.0 ± 8.3 minutes with TOT surgery. A longer period of time was required for TVT surgery (p = 0.025). The residual urine at post-operative day 1 was higher in TVT surgery (25.9 ± 44.2 ml) than in TOT surgery (10.6 ± 19.2 ml) (p = 0.0452). The surgical duration of TVT surgery was shortened after the operator had performed 15 operations (p = 0.019).


In comparison of TVT surgery and TOT surgery, the surgical duration of TVT surgery was longer and the residual urine of TVT surgery was higher at post-operative day 1. Surgical experience could shorten the duration of TVT surgery.

Stress urinary incontinence; TVT surgery; TOT surgery