Clinical and urodynamic repercussions after TVT procedure and how to diminish patient complaints.
OBJECTIVE
Analysis of changes in voiding patterns after sub-urethral TVT procedure: urodynamic variations and clinical repercussions.


METHODS
112 women included in an ethics committee protocol (CCPPRB ) with a mean follow-up of 22 months underwent complete urodynamic testing before and after TVT procedure and filled in pre- and post-operative questionnaires.


RESULTS
Analysis of the questionnaires showed that two clinical symptoms were predominant post-operatively: dysuria and micturitional urge. The urodynamic profiles showed that TVT banding led to infravesical obstruction but not to significant detrusor overactivity.


CONCLUSIONS
Our results show that clinical changes induced by the TVT procedure were due to infravesical obstruction, and that there was no progression of detrusor overactivity. We suggest two ways to avoid, or diminish, this post-operative obstruction, or to detect patients at risk from obstruction: training for women who use their abdominal muscles for voiding rather than their detrusor, or pre-operative screening of hypotonic bladders.
Gateau
T
T
Department of Urology, Pellegrin University Hospital, 33076, Bordeaux, France.
Faramarzi-Roques
R
R
Le Normand
L
L
Glemain
P
P
Buzelin
J M
JM
Ballanger
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006406:Hematoma / Q000209:etiology / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D017060:Patient Satisfaction; D011446:Prospective Studies; D019736:Prostheses and Implants / Q000009:adverse effects*; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000293:injuries; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000601:surgery*; D016055:Urinary Retention / Q000209:etiology; D014554:Urination; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D014621:Vagina / Q000601:surgery*