title: The effects of the tension-free vaginal tape on proximal urethral position: a prospective, longitudinal evaluation.
abstract: 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.
authors.affiliation: Female Pelvic Medicine and Reconstructive Surgery, UCSD Department of Reproductive Medicine, 200 West Arbor Drive, #8433, San Diego, CA 92103, USA. mimilukacz@aol.com
authors.forename: Emily S
authors.initials: ES
authors.lastname: Lukacz
authors.forename: Karl M
authors.initials: KM
authors.lastname: Luber
authors.forename: Charles W
authors.initials: CW
authors.lastname: Nager
mesh_terms: 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*
chemical_list: D011126:Polypropylenes