Does the tension-free vaginal tape stay where you put it?
OBJECTIVE
The tension-free vaginal tape (TVT) is a widely used procedure for the surgical treatment of urodynamic stress incontinence. Long-term follow-up data remain scarce. It has been speculated that scar formation leads to tape shortening and stiffening. This study was designed to longitudinally investigate tape position and mobility.


METHODS
An observational clinical study was performed using ultrasound parameters of tape position and mobility on Valsalva maneuver as main outcome parameters.


RESULTS
Of 92 women eligible for a minimum of two postoperative assessments, 72 (78%) attended at least twice after TVT placement, at a median interval of 1.6 years. Sixty-eight data sets remained after exclusion of 4 patients who had undergone tape division. At the last visit, the tape was found to be more caudal, at rest (P <.001) and on Valsalva maneuver (P =.002). Tape mobility on Valsalva maneuver remained virtually unchanged.


CONCLUSIONS
The TVT does not seem to contract or shorten over a median observation period of 1.6 years. On the contrary, it appears to slowly migrate caudally.
Dietz
Hans Peter
HP
Royal Hospital for Women and the University of New South Wales, Sydney, Australia. hpdietz@bigpond.com
Mouritsen
Lone
L
Ellis
Gaye
G
Wilson
Peter Donald
PD
D000328:Adult; D000368:Aged; D005260:Female; D005548:Foreign-Body Migration / Q000503:physiopathology; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D019736:Prostheses and Implants / Q000009:adverse effects; D011475:Prosthesis Failure; D013997:Time Factors; D014463:Ultrasonography; D001743:Urinary Bladder / Q000000981:diagnostic imaging; D014550:Urinary Incontinence, Stress / Q000000981:diagnostic imaging / Q000601:surgery*; D013520:Urologic Surgical Procedures; D014621:Vagina / Q000000981:diagnostic imaging; D014636:Valsalva Maneuver