TVT rivals Burch for Incontinence Tx. (Two Years of Data).

DALLAS -- With 2-year prospective data now in, tension-free vaginal tape continues to hold up as an alternative to Burch colposuspension for genuine stress incontinence.

Cure rates and quality of life indices remain comparable, and around 90% of patients who have undergone the tension-free vaginal tape (TVT) procedure are satisfied, Dr. Paul Hilton said at the annual meeting of the Society of Gynecologic Surgeons.

Six-month data from the United Kingdom and Ireland Trial Group study which randomized 344 women to one of the two procedures, found that only about 10% of patients in the TVT group and 15% of the colposuspension group continued to evidence urodynamic findings of incontinence.

Cure rates for the two procedures now stand at 68.8% in the TVT group and 66.4% in the colposuspension group. Cure was defined as a negative cystometrogram and pad test, said Dr. Hilton, clinical director of women's services at the Royal Victoria Infirmary, Newcastle upon Tyne, England.

"These numbers are lower than those reported in the literature for either procedure," he said. The reason for this is that substantial numbers of patients in the British study have not continued to return for longer-term follow-up. "These numbers reflect an intent to treat analysis, which we used because we wanted to avoid potentially biasing the result toward the new procedure," he said.

If the cure rate is based on the 269 patients for whom complete data are available, the numbers are 79% for both groups. This is closer to the 85%-90% cure rates reported in the literature, Dr. Hilton said.

Significant differences between the two procedures are becoming evident. For example, time to return to normal activities averages 2-3 weeks after TVT and 4-8 weeks after colposuspension. Time until return to work typically is 3-4 weeks after TVT, and 8-12 weeks following colposuspension, Dr. Hilton said.