Comparison of the Transobturator Tape and Minisling Methods in the Treatment of Stress Urinary Incontinence

Abstract

Background: This study aims to evaluate and compare the transobturator tape and minisling surgical techniques in the treatment of stress urinary incontinence, focusing on their effectiveness and postoperative outcomes. Methods: This retrospective analysis included 113 patients who underwent midurethral sling surgery for stress urinary incontinence at Islahiye State Hospital between January 2016 and October 2022. The patients were divided into two groups: Those treated with transobturator tape (Group 1, n = 70) and those treated with minisling (Group 2, n = 43). Data were collected from medical records and follow-up interviews. The variables assessed included demographics (age and body mass index), preoperative and postoperative Urinary Incontinence Quality of Life Scale scores, and postoperative pain details. Operative details, such as procedure duration and hospital stay length, were recorded. Patients were also asked about postoperative symptoms, including groin pain and dyspareunia. Additionally, the duration of symptom-free months following surgery was documented. Binary logistic regression analysis was conducted to evaluate the effect of surgical methods on long-term well-being. Results: The transobturator tape and minisling techniques demonstrated similar improvements in postoperative Urinary Incontinence Quality of Life Scale scores (p = 0.213). However, the minisling procedure had significantly shorter operative time (29.2 min vs. 52.2 min, p <0.001) and hospital stay (1.33 days vs. 1.96 days, p = 0.003) than transobturator tape. Postoperative complications were notably higher in the transobturator tape group, with significantly more patients reporting groin pain (28.6% vs. 4.7%, p = 0.002) and dyspareunia (20.0% vs. 0.0%, p = 0.002). Logistic regression analysis identified surgical method as the primary predictor of long-term well-being beyond one year (p = 0.040). Conclusions: While the transobturator tape and minisling surgeries are effective for treating stress urinary incontinence, the minisling method offers advantages, such as shorter operative time, reduced hospital stay, and fewer postoperative complications, over the transobturator tape method. These findings suggest that the minisling approach may provide a more favorable patient experience, particularly due to reduced postoperative pain and quick recovery, than the transobturator tape method.