Prospective comparison of the ‘inside–out’ and ‘outside–in’ transobturator-tape procedures for the treatment of female stress urinary incontinence

The aim of this study was to prospectively compare the efficacy and safety of ‘inside–out’ (TVT-O) and ‘outside–in’ (TOT) transobturator tape procedures for treatment of female stress urinary incontinence (SUI). One hundred women with SUI were alternately assigned to TVT-O (n = 50) or TOT (n = 50). About 1 year after surgery, we compared surgical outcomes in the two groups. TVT-O and TOT showed similar rates of cure (86 vs 92%). Approximately 1 year after surgery, Incontinence Quality of Life questionnaire parameters improved significantly in both groups (p < 0.05), but the two groups did not differ (p > 0.05). The rates of patient satisfaction with TVT-O and TOT (96 vs 98%) were similar. These preliminary results suggest that TVT-O and TOT are equally effective and safe procedures for women with SUI. However, this study was unable to identify a difference between the two procedures due to the underpowered nature of the study.