DALLAS June 2, 2010 As part of a national clinical trial, UT Southwestern Medical Center researchers found little difference in effectiveness between two popular treatments for one of the most common ailments among American women: stress urinary incontinence.
Stress incontinence affects up to 50 percent of women in the U.S. at some point in their lives. Women with stress incontinence experience leakage during increases in abdominal pressure typically brought on by sneezing, coughing, lifting heavy objects or other types of physical activities. UT Southwestern surgeons and colleagues at eight other sites compared the outcomes of two surgical procedures designed to alleviate symptoms of stress urinary incontinence. UT Southwestern was the only site in North Texas to participate in the trial.
The study, available online in the New England Journal of Medicine, shows that both surgical procedures transvaginal sling (TVT) and transobturator midurethral sling (TOT) appear to be similarly effective in women up to 12 months after the procedures were performed.
"Both procedures are done using minimally invasive techniques, but until now there haven't been any large prospective head-to-head randomized trials comparing the two popular techniques," said Dr. Gary Lemack, professor of urology and neurology and co-principal investigator at the UT Southwestern site.
The TVT sling, introduced in 1996, involves placing a thin strip of polypropylene mesh weave transvaginally and behind the urethra and pubic bone. The strip acts as a kind of scaffolding that supports the urethra, diminishing urine leakage.
The more recently developed TOT sling reduces the risk of bladder or bowel injury by passing the sling laterally into the groin through two small incisions in the upper thigh. This method works in the same way as the TVT, by supporting the urethra. Controversy exists as to which sling is more effective and which might
|Contact: Katherine Morales|
UT Southwestern Medical Center