Comparison of the Long-term Treatment Outcome Between Pubovaginal and Transobturator Suburethral Sling for Stress Urinary Incontinence in Women

Q: What is the study purpose regarding PVS and TOT for SUI?

The study compares long-term treatment outcomes between pubovaginal sling and transobturator suburethral sling for women with stress urinary incontinence, and assesses whether adding colporrhaphy improves results.

Q: How were the participants grouped and what was the primary outcome?

Five hundred thirty-three women were divided into four groups: PVS alone, PVS with colporrhaphy, TOT alone, and TOT with colporrhaphy. The primary outcome was the long-term cumulative success rate, defined as being dry or using fewer than 1 pad per day.

Q: Which approach showed better long-term success and what were the symptom differences?

PVS groups had significantly higher long-term cumulative success than TOT groups. The highest success occurred with PVS plus concurrent colporrhaphy, while persistent overactive bladder symptoms were highest in the TOT-alone group.

Sep 30, 2026

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Purpose: To evaluate long-term outcomes of pubovaginal sling (PVS) versus transobturator suburethral sling (TOT) for women with stress urinary incontinence (SUI), including the effect of concomitant anterior colporrhaphy. Methods: A retrospective review of 533 women with mixed urinary incontinence and predominant SUI compared four groups (PVS alone, PVS with colporrhaphy, TOT alone, TOT with colporrhaphy). Primary endpoint was long-term cumulative success (dry or <1 pad/day), with secondary postoperative symptom and perioperative complication outcomes.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Abstract

Purpose

Methods

Results

Conclusions

Introduction

Definition and prevalence of SUI

Risk factors and diagnosis

Treatment options and surgical context

Original Article Int Neurourol J 2025;29(4):248-254 [https://doi.org/10.5213/inj.2550078.039](https://doi.org/10.5213/inj.2550078.039)[ ](https://doi.org/10.5213/inj.2550078.039)pISSN 2093-4777 · eISSN 2093-6931 Comparison of the Long-term Treatment Outcome Between Pubovaginal and Transobturator Suburethral Sling for Stress Urinary Incontinence in Women Yi-Hsuan Wu1, Yuan-Hong Jiang2, Sheng-Fu Chen2, Hann-Chorng Kuo2 1Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan 2Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan Purpose: Stress urinary incontinence (SUI) affects women worldwide, and surgery remains important for those who do not respond to conservative management. Methods: We retrospectively reviewed the medical records of 533 female patients with mixed urinary incontinence and predominant SUI treated at a medical center. Some patients may have had stage 3 or higher cystocele and underwent concomitant anterior colporrhaphy. Patients were divided into 4 groups: pubovaginal sling (PVS) alone, PVS with colporrhaphy, transobturator suburethral sling (TOT) alone, and TOT with colporrhaphy. The primary outcome was the long-term cumulative success rate in each group, and a successful outcome was defined as being dry or using fewer than 1 pad per day. The secondary outcomes included subjective postoperative lower urinary tract symptoms and various perioperative complications. Results: The long-term cumulative success rates ofthe PVS groups, with or without colporrhaphy, were significantly higher than those ofthe TOT groups, with or without colporrhaphy (P < 0.001). The group receiving PVS with concurrent colporrhaphy demonstrated the highest success rate, followed by PVS alone, TOT with colporrhaphy, and TOT alone (P = 0.003). In addition, the highest rate of persistent overactive bladder symptoms was observed in the TOT-alone group (P < 0.001). Conclusions: This study suggests that PVS is superior to TOT in controlling incontinence symptoms and achieving long-term success. Concurrent colporrhaphy may also contribute to improved anti-incontinence outcomes. Keywords: Stress urinary incontinence; Pubovaginal sling; Transobturator sling; Colporrhaphy; Success rate • Grant/Fund Support: This study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. • Research Ethics: This study was approved by the Research Ethics Committee of Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation (IRB No. 113-040-B), and the requirement for informed consent was waived due to the retrospective study design. • Conflict of Interest: No potential conflict of interest relevant to this article was reported. INTRODUCTION Stress urinary incontinence (SUI) is defined as involuntary urine leakage that occurs when intra-abdominal pressure in- creases, such as during coughing, heavy lifting, or physical activity. SUI affects adult women worldwide, with an estimated overall prevalence of approximately 46%[1]. The underlying mechanisms of SUI involve 2 major factors: urethral hypermo- Corresponding author: Hann-Chorng Kuo [https://orcid.org/0000-0001-7165-4771](https://orcid.org/0000-0001-7165-4771) Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, No. 707, Section 3, Chung Yang Road, Hualien 970, Taiwan [Email: hck@tzuchi.com.tw](Email: hck@tzuchi.com.tw) Submitted: February 17, 2025 / Accepted after revision: May 31, 2025 This is an Open Access article distributed under the terms of the Cre ative Commons Attribution Non-Commercial License ([https://creative](https://creative)[commons.org/licenses/by-nc/4.0/](commons.org/licenses/by-nc/4.0/)) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cit

FAQs

What is the study purpose regarding PVS and TOT for SUI?

The study compares long-term treatment outcomes between pubovaginal sling and transobturator suburethral sling for women with stress urinary incontinence, and assesses whether adding colporrhaphy improves results.

How were the participants grouped and what was the primary outcome?

Five hundred thirty-three women were divided into four groups: PVS alone, PVS with colporrhaphy, TOT alone, and TOT with colporrhaphy. The primary outcome was the long-term cumulative success rate, defined as being dry or using fewer than 1 pad per day.

Which approach showed better long-term success and what were the symptom differences?

PVS groups had significantly higher long-term cumulative success than TOT groups. The highest success occurred with PVS plus concurrent colporrhaphy, while persistent overactive bladder symptoms were highest in the TOT-alone group.

Sep 30, 2026

Uploaded by eBook King