The effects of the tension-free vaginal tape on proximal urethral position: a prospective, longitudinal evaluation.
This study was designed to determine the anatomic effects of the tension-free vaginal tape (TVT). A cohort of 94 patients was followed for 1 year. Urethral position was quantified using the Q-tip angle. Statistical analysis employed the ANOVA and paired t tests. A total of 54 (57%) patients met the criteria for analysis. In these 54 patients the success rate was 81%. Straining Q-tip angles decreased from a mean preoperative value of 52 degrees to 28 degrees before 1 month, 34 degrees at 1-6 months, 41 degrees at 6-12 months, and 45 degrees at 1 year ( P <0.05). The postoperative resting angles remained essentially unchanged. The sling initially provides support to the proximal urethra which diminishes over time. Unchanged resting Q-tip angles confirm the tension-free concept and there appears to be no shrinkage or tightening of the sling. We concluded that the success of the TVT is not due to proximal urethral support.
Lukacz
Emily S
ES
Female Pelvic Medicine and Reconstructive Surgery, UCSD Department of Reproductive Medicine, 200 West Arbor Drive, #8433, San Diego, CA 92103, USA. mimilukacz@aol.com
Luber
Karl M
KM
Nager
Charles W
CW
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D011126:Polypropylenes; D011446:Prospective Studies; D019736:Prostheses and Implants; D013526:Surgical Mesh; D013997:Time Factors; D014521:Urethra / Q000033:anatomy & histology* / Q000502:physiology; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014621:Vagina / Q000601:surgery*
D011126:Polypropylenes