Efficacy of tension-free vaginal tape with other pelvic reconstructive surgery.
OBJECTIVE
The tension-free vaginal tape procedure has been shown in several studies to be a safe and effective method of correcting stress urinary incontinence, but its efficacy when combined with other pelvic surgery has not been examined.


METHODS
Thirty-seven women with stress or mixed urinary incontinence and other pelvic floor defects underwent the tension-free vaginal tape procedure in conjunction with other pelvic floor reconstructive surgery. Preoperative and postoperative voiding diaries, standing stress test results, and patient satisfaction were evaluated. Patient outcome, operative difficulties, and complications are discussed.


RESULTS
Thirty-five of 37 patients were completely dry (94%) 6 months after surgery. One patient (2.7%) had a recurrent pelvic floor defect. Four of 37 (10.8%) noted postoperative urgency that required treatment. The overall complication rate was 18.9%: the most common complication was urinary retention (43%); mean number of days with a catheter was 5.1 (range, 0-21 days). No serious operative complications occurred. Nine of 9 (100%) patients who underwent a repeat anti-incontinence procedure were cured with no increase in the complication rate.


CONCLUSIONS
The tension-free vaginal tape procedure is safe and efficacious when combined with other pelvic floor reconstructive surgery. Postoperative urinary retention was the most common complication.
Partoll
Linda M
LM
Department of Obstetrics and Gynecology, University of Washington, Spokane, USA.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D017773:Pelvic Floor / Q000601:surgery*; D013526:Surgical Mesh; D013997:Time Factors; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000601:surgery*; D016055:Urinary Retention / Q000209:etiology; D014552:Urinary Tract Infections / Q000209:etiology; D014554:Urination; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation*; D014621:Vagina / Q000601:surgery*