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.
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.
Authors: Jerry G Blaivas; Rajveer S Purohit; Matthew S Benedon; Gabriel Mekel; Michael Stern; Mubashir Billah; Kola Olugbade; Robert Bendavid; Vladimir Iakovlev Journal: Nat Rev Urol Date: 2015-08-18 Impact factor: 14.432