title: Results of the tension-free vaginal tape procedure for stress incontinence: patient's perspective.
abstract: BACKGROUND
  To evaluate the results of the tension-free vaginal tape procedure (TVT) from a patient's perspective.
  
  
  METHODS
  Between May 1999 and January 2002, 90 patients underwent a TVT for genuine stress incontinence (GSI) and mixed incontinence. Prior to the procedure, GSI was confirmed by clinical examination and urodynamic studies. Results were then audited from patient notes and the same patients were sent questionnaires to examine results from a patient perspective.
  
  
  RESULTS
  Overall response rate to the questionnaire was 70 (77%). The mean age of the patients was 50.4 years (range 31-83 years). Sixty-one patients had spinal anesthesia, seven had general anesthesia and two had local anesthesia. Mean hospital stay was 3.36 days (range 2-14 days) and mean period from the operation to the time of the survey and audit was 16.34 months (range 3-28; SD 6.92). Thirty-nine (56%) of the 70 patients who answered said that the operation had cured their incontinence, 16 (23%) had an improvement in their symptoms, 7 (10%) had worsening of their symptoms and 8 (11%) felt that the operation did not make any difference. The overall success rate according to the patients' perspective was 79%, whereas our audit showed an overall success rate of 86% (77% and 82%, respectively, when we compared only the 66 patients who had both notes and replies available for analysis).
  
  
  CONCLUSIONS
  Although a patient's perception regarding the success of TVT tends to differ from that of a clinician, it was not found to be statistically significant (P = 0.22, McNemar test). The TVT is a very successful operation, but realistic cure rates should be offered to patients.
authors.affiliation: Department of Urology, Stepping Hill Hospital, Stockport, UK. armanikan@aol.com
authors.forename: Ramaswamy
authors.initials: R
authors.lastname: Manikandan
authors.forename: Magda
authors.initials: M
authors.lastname: Kujawa
authors.forename: Evelyn
authors.initials: E
authors.lastname: Pearson
authors.forename: Patrick H
authors.initials: PH
authors.lastname: O'Reilly
authors.forename: Stephen C W
authors.initials: SC
authors.lastname: Brown
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008485:Medical Audit; D008875:Middle Aged; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D006113:United Kingdom; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D014621:Vagina / Q000601:surgery*