Objective and subjective cure rates after tension-free vaginal tape for treatment of urinary incontinence.
OBJECTIVE
To assess the objective and subjective cure rates after the tension-free vaginal tape (TVT) procedure in women with urinary incontinence.


METHODS
We performed a retrospective analysis of 112 consecutive women with genuine stress (n = 88) and mixed (n = 24) incontinence. The objective cure rate was evaluated by clinical and urodynamic examinations and the subjective cure rate using the Contilife questionnaire. The mean follow-up time was 25 months (range 18 to 34).


RESULTS
The mean operative time was 30 minutes (range 25 to 50). Most patients (58%) underwent surgery with locoregional anesthesia. The overall complication rate was 37.5% (42 of 112). The perioperative complication rate was 14.3%, including 13 bladder injuries (11.6%). Five (38.5%) of the latter occurred in 7 patients with a previous history of incontinence surgery (P <0.001). The early postoperative complication rate was 32.1%. The main complication was voiding difficulties, diagnosed in 14 patients. Ten (71.4%) required intermittent self-catheterization for less than 15 days and four for a mean duration of 28 days (range 15 to 90). The late postoperative complication rate was 29.4%, including 29 cases of de novo urge symptoms (25.9%). Anticholinergic drugs were effective in only 15 (51.7%) of the 29. The objective cure rate was 89.3%. No difference was found between patients with genuine stress incontinence and those with mixed incontinence. The subjective cure rate was 66%. The difference in cure rates between the objective and subjective evaluations was significant (P <0.05). The subjective cure rate in patients with de novo urge symptoms was 37.9%.


CONCLUSIONS
Our results demonstrate that the TVT procedure is a safe and effective surgical method. The lower subjective cure rate was related to the high incidence of de novo urge symptoms.
Jeffry
L
L
Service de Gynécologie, Hôpital Hôtel-Dieu de Paris, Assistance Publique des Hôpitaux de Paris, Paris, France.
Deval
B
B
Birsan
A
A
Soriano
D
D
Daraï
E
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D013536:Suture Techniques / Q000009:adverse effects; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014621:Vagina / Q000601:surgery*