Prolonged Results After Tvt And Tot Operations: A Systematic Review of 2020–2025 Evidence

Abstrak

Background: Mid-urethral sling (MUS) procedures, including tension-free vaginal tape (TVT) and transobturator tape (TOT), have become the gold standard in the surgical treatment of stress urinary incontinence (SUI). With rising global concerns about mesh safety, the long-term outcomes of these interventions have gained renewed importance.
Aim: To evaluate prolonged (≥5–10 year) postoperative outcomes of TVT and TOT procedures using evidence published between 2020 and 2025.
Methods: A structured review of randomized controlled trials, cohort studies, national registry analyses, imaging studies, and case reports from 2020–2025. The primary endpoints included long-term efficacy, recurrence, complications, mesh-related events, quality of life outcomes, and reoperation rates.
Results: Long-term follow-up data indicate sustained improvement in continence rates after both TVT and TOT, with retropubic TVT demonstrating slightly higher durability in some cohorts. Complication patterns differ: TOT is associated with groin pain, while TVT has higher rates of voiding dysfunction and bladder injury. Late mesh exposure, de novo urgency, and occasional erosions beyond 10 years are documented. Patient satisfaction remains high (>70%) at 10–20 years but declines gradually with time.
Conclusion: Both TVT and TOT remain effective long-term treatments for SUI, but complications may arise even after a decade. Individualized patient selection, long-term follow-up, and improved management strategies for mesh complications are essential.

Kata Kunci