A prospective observational cohort study comparing perioperative outcomes, complications, and quality of life between surgical procedures for female stress urinary incontinence

To compare perioperative outcomes, complications, and quality of life between tension-free vaginal tape obturator (TVT-O) and retropubic tension-free vaginal tape exact (TVT-E) procedures for female severe stress urinary incontinence (SUI). This prospective cohort study enrolled women undergoing surgery for severe stress urinary incontinence (December 2023-February 2025). Patients were grouped by procedure (TVT-O vs. TVT-E). We compared perioperative data, complications, quality-of-life scores (ICI-Q-SF, IIQ-7, PISQ-12 at 6 and 12 months), and 12-month objective cure rates. Kaplan-Meier curves assessed cumulative recurrence. Of 120 patients enrolled (TVT-O: 66; TVT-E: 54), baseline characteristics were comparable ( P > 0.05). Operative time was significantly shorter in the TVT-O group ( P < 0.001), with no significant differences in blood loss, catheterization time, or hospital stay. Complication rates were similar (TVT-O: 21.21% vs. TVT-E: 18.52%, P = 0.710), including specific complications like groin pain. Both groups showed significant postoperative quality-of-life improvements ( P < 0.001), but between-group differences were not significant. At 12 months, objective cure rates and cumulative recurrence-free survival were comparable between groups. Both TVT-O and TVT-E are safe and effective for severe SUI, significantly improving quality of life. TVT-O offers shorter operative time with equivalent efficacy and complication rates to TVT-E.