الفهرس 
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Abstract
This is a prospective randomized study aims at comparing the effectiveness and safety of TVT and TOT as a treatment of SUI. Between January 2006 through December 2008, 40 patients underwent either procedure (19 patients had TVT vs. 21 had TOT) at UNC, Mansoura, Egypt. Both groups showed similar demographic, clinical and laboratory features after passing a standardized preoperative evaluation.
The two procedures were done under spinal anesthesia where the operative time and blood loss were comparable in both groups. Nine (47.4%) patients in TVT group and 10(47.6%) in TOT group had grade II cystocele and accordingly they had concomitant anterior colporrhaphy which was done after placement of the tape in both groups.
There was no statistical difference between both groups with regard to stress specific and overall success rate when it was evaluated for consequent follow up visits. We found that incidence of success at 3 month was 100 % for TVT vs.85.7 % for TOT. It was clear that this clinical difference was getting more obvious with time. At nearly 20 months follow up stress specific success rate was 94.7 % for TVT vs. 81% for TOT(p 0.3) while, overall success rate for TVT group was nearly significantly higher than TOT group at one year follow up (93.8% Vs 66.6% P=0.06). Both groups reported equal improvement in quality of life as evidenced by IIQ-7 and UDI-6 questionnaires. A serious complication in the form of expanding haematoma was encountered in one patient with TVT and was managed conservatively. Thigh pain was noticed in 3 patients from TOT group.
From our results we can conclude the following:
Both TVT and TOT are effective procedures for treatment of SUI. Both treatment modalities can be applied to patients having combined cystocele and SUI where concomitant colporrhaphy can be done after sling fixation in either group. When compared to each other, it seemed that TOT might be inferior to TVT in terms of efficacy, causing significant thigh pain. However, a larger smaple size is needed to draw a final conclusion. There is a need to find a standard way for definition of success and evaluation of complications of such techniques.