title: The effects of the tension-free vaginal tape on voiding function: a prospective evaluation.
abstract: The impact of tension-free vaginal tape (TVT) on voiding function was studied in a cohort of 103 patients. Voiding was assessed with quality of life questionnaires, non-invasive urine flow and voiding pressure-flow studies both preoperatively and 1 year postoperatively. Paired t-tests and Wilcoxon's signed ranks tests were used for analysis. Data from 65 patients were analyzed. Subjective voiding function did not change; however, maximum flow rates decreased by up to 43%: from 29 ml/s to 16 ml/s on free flow studies. This was associated with a 27% increase in detrusor pressure at maximum flow: from 15 to 19 cmH(2)O. Postvoid residuals were not clinically different, changing from a median of 15 ml to 30 ml postoperatively. Thirty-eight patients (37%) required postoperative catheterization for urinary retention (median duration 4 days). We concluded that the TVT sling reduces maximum flow rates without clinically significant effects on detrusor pressure, residual urine or subjective voiding.
authors.affiliation: Department of Reproductive Medicine, UCSD Medical Center, 200 West Arbor Drive, 8433, San Diego, CA 92103, USA. elukacz@uscd.edu
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: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D011312:Pressure; D019736:Prostheses and Implants; D011788:Quality of Life; D014546:Urinary Catheterization; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000295:instrumentation* / Q000379:methods*; D014621:Vagina / Q000601:surgery*