JOURNAL ARTICLE

Tension-free vaginal tape - a suitable procedure for patients with recurrent stress urinary incontinence

Seija Ala-Nissilä, Mervi Haarala, Juha Mäkinen
Acta Obstetricia et Gynecologica Scandinavica 2010, 89 (2): 210-6
20121336

OBJECTIVE: To evaluate the efficacy of the tension-free vaginal tape operation (TVT) in patients with and without previous anti-incontinence surgery.

DESIGN: Prospective follow-up study.

SETTING: University hospital in Finland.

POPULATION: A total of 130 women who had a TVT procedure from August 1998 to December 2002.

MAIN OUTCOME MEASURES: Subjective cure, complications and voiding symptoms.

METHODS: Sixty women with recurrent (group A) and 70 women with primary stress urinary incontinence (SUI) (group B) were compared. One follow-up visit took place two months postoperatively and a questionnaire-based evaluation was carried out three years after operation. Further information was collected a mean of eight years after the operation.

RESULTS: There was no difference in the transient postoperative retention rate (17 vs. 19%, p = 0.78) and number of complications (20 vs. 13%, p = 0.29) between group A and group B. At two months after operation, 85% of patients in group A and 94% in group B were cured of SUI and were satisfied with the operative result (p = 0.096). The satisfaction rates at three years were 86 and 91% in groups A and B, respectively, and cure rate of SUI was 93% in both groups. At follow-up, 20% of the patients in group A and 5.7% in group B (p = 0.013) had de novo urge symptoms and the rate of voiding difficulties increased especially in group B women over time.

CONCLUSIONS: TVT results in the same cure and complication rates when performed for primary SUI and recurrent SUI. The procedure is effective and associated with a low and acceptable level of complications. It is well suited to treat also recurrent SUI.

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