Outcome of the use of tension-free vaginal tape in women with mixed urinary incontinence, previous failed surgery, or low valsalva pressure
Article first published online: 12 JAN 2005
Journal of Obstetrics and Gynaecology Research
Volume 31, Issue 1, pages 38–42, February 2005
How to Cite
Abdel-Hady, E.-S. and Constantine, G. (2005), Outcome of the use of tension-free vaginal tape in women with mixed urinary incontinence, previous failed surgery, or low valsalva pressure. Journal of Obstetrics and Gynaecology Research, 31: 38–42. doi: 10.1111/j.1447-0756.2005.00238.x
- Issue published online: 12 JAN 2005
- Article first published online: 12 JAN 2005
- Received: April 22 2004. Accepted: October 8 2004.
- stress urinary incontinence;
- tension-free vaginal tape
Aim: To assess the safety and efficacy of the use of tension-free vaginal tape (TVT) for the treatment of stress urinary incontinence (SUI) in women with mixed incontinence, previous failed incontinence surgery or low valsalva leak point pressure (VLPP).
Methods: Six hundred and fifty-eight women with SUI underwent the TVT procedure. These included women with mixed stress and urge incontinence (n = 128), previous surgery for SUI (n = 118), low VLPP (n = 80), and those over 70 years old (n = 68). The procedure was carried out under spinal anesthetic and operative and immediate postoperative data was collected for all women. Six-month follow-up data was available on 454 women, with the first 300 women completing a quality of life (QOL) questionnaire before and after surgery.
Results: The overall subjective cure rate at 6 months was 91%, with 8% of women reporting significant (>50%) improvement in their symptoms. Subgroups with a body mass index > 30, age > 70 years, coexisting instability, previous failed surgery, and low VLPP showed cure rates of 81–89%. QOL improvements for all groups were highly significant. Significant complications included voiding difficulties in 29 women (4.4%), retropubic hematomas in four (0.6%), and thromboembolic episodes in three (0.5%).
Conclusion: The simplicity and high efficacy of the TVT makes it the first choice for the treatment of women with SUI, including those with more complex problems or coexisting risk factors.