Comparative study of autologous pubovaginal sling and synthetic transobturator (TOT) SAFYRE sling in the treatment of stress urinary incontinence

Purpose: To compare short-term results of autologous pubovaginal sling and synthetic transobturator (TOT) SAFYRE sling in the treatment of female stress urinary incontinence (SUI). Methods: Twenty women referred for surgical treatment of SUI were assigned randomly to autologous pubovaginal sling or synthetic TOT sling. Inclusion criteria were primary treatment of SUI and urodynamic study showing SUI without detrusor overactivity. Pre- and postoperative quantification of the severity of incontinence was done by pad test and a validated questionnaire (King’s Health Questionnaire). Results: There were no differences in patients’ mean age, parity, body mass index, rate of postmenopausal state, pelvic floor defects and mean Valsalva leak point pressure in the preoperative urodynamic study. Mean operating time (21.1 ± 3.8 vs. 69.5 ± 23.7 min; P<0.001) and hospital stay (28.8 ± 8.4 vs. 44.4 ± 5.8 h; P<0.001) was shorter in the TOT than the autologous group. The postoperative pad test (39.4 ± 12.5 vs. 8.4 ± 5.2 g; P=0.01) and the absent in the improvement in the quality of life were significantly higher in the TOT group. Conclusion: Our initial results suggest that the synthetic TOT technique had worse effectiveness for treating female SUI compared to autologous pubovaginal sling.