Tension-free vaginal tape obturator: midterm data on an operative procedure for the cure of female stress urinary incontinence performed on 100 patients.

STUDY OBJECTIVE: To evaluate the midterm therapeutic results of a minimally invasive anti-incontinence operative procedure, the tension-free vaginal tape (TVT) obturator.

DESIGN: With this prospective, observational, and consecutive patient series, the TVT obturator procedure was performed by the same surgeon on 100 patients. Follow-up lasted 30 to 36 months.

SETTING: Operative theaters of Assuta medical centers private hospitals.

PATIENTS: One hundred female patients with urodynamically proven stress urinary incontinence.

INTERVENTIONS: TVT obturator operations were performed for all patients.

MEASUREMENTS AND MAIN RESULTS: Demographic and therapeutic aspects of the patient group data were evaluated. Clinical signs for bowel, urethral, or bladder injuries were undetectable with this TVT obturator patient group. Intraoperative bleeding, postoperative field infections, or postoperative pelvic floor relaxations were not noted. The therapeutic failure rate for the TVT obturator procedure was 8.0% (8 of 100 patients) after 1 year, whereas the midterm failure rate was 10.8% (10 of 93 patients). Six of the 10 patients with TVT obturator failure underwent interval TVT operations with satisfactory results. The overall midterm satisfaction rate for this study group of patients was 89.2% (83 of 93 patients), 6 (6.5%) of those patients were improved only, yet still with minimal residual urinary leakage.

CONCLUSION: Use of the TVT obturator, a midurethral sling, did not involve bladder penetration and was complicated by a low rate of postoperative outlet obstruction. The midterm therapeutic results and the cost-effectiveness of the TVT obturator appear similar to previously reported midurethral sling operations. Long-term comparative data collection is required to enable drawing solid conclusions regarding the appropriate position of this operative technique within the spectrum of antiincontinence operations.