# Suburethral Adjustment With 8/4 Calibration Versus Conventional Technique in Transobturator Tape (TOT) Placement: A Comparative Clinical Study

## TL;DR

This study compares two techniques for treating stress urinary incontinence and finds that the 8/4 adjustment method has fewer complications and shorter surgery time.

## Contribution

The study introduces the 8/4 calibration technique as a safer and more efficient alternative to the conventional TOT placement method.

## Key findings

- The 8/4 technique had a significantly shorter surgical duration compared to the conventional method.
- The 8/4 group had a lower incidence of medium-term postoperative complications.
- Both techniques improved quality of life similarly after surgery.

## Abstract

Objective

To compare the postoperative clinical outcomes of suburethral adjustment with 8/4 calibration versus the conventional technique in the placement of transobturator suburethral tape (TOT) for female stress urinary incontinence.

Materials and methods

A prospective, longitudinal, and analytical cohort study was conducted on 60 women diagnosed with stress or mixed urinary incontinence with a predominance of stress, treated at the "Dr. Alejandro Dávila Bolaños" Military School Hospital in Managua, Nicaragua. Participants were assigned by convenience sampling to two groups: 40 women received the conventional surgical technique and 20 were treated with the 8/4 adjustment technique. Demographic characteristics, surgical procedure duration, length of hospital stay, presence of complications, and quality of life, the latter measured by the ICIQ-SF questionnaire, were evaluated.

Results

The average age was similar in both groups (~54 years). The surgical procedure duration was significantly shorter in the group treated with the 8/4 technique (23 min 47 sec vs. 27 min 30 sec; p=0.03, independent samples t-test). No significant differences were observed in the length of hospital stay or the incidence of immediate complications (at 24 hours and 10 days post-surgery) between the groups (p > 0.05, Chi-square test). At three months, the conventional technique group had a higher incidence of complications (22.5% vs. 5%; p=0.02, independent t-test). Quality of life significantly improved in both groups after surgery (p < 0.01, paired t-test), with no significant differences in the degree of improvement between them (p=0.45, independent t-test).

Conclusion

The 8/4 adjustment technique proved to be a safe and effective option for the treatment of stress urinary incontinence, associated with a lower incidence of medium-term postoperative complications, without compromising the improvement in quality of life compared to the conventional technique. These findings suggest that the 8/4 adjustment represents an advantageous alternative that could be considered in clinical practice.