Is the cough-stress test necessary when placing the tension-free vaginal tape?
OBJECTIVE
To estimate whether the mode of anesthesia (and the resultant ability or inability to perform the cough-stress test) used during the tension-free vaginal tape (TVT) procedure affects postoperative continence.


METHODS
A cohort of 170 women who underwent the TVT procedure without any other concomitant surgery completed the short form of the Urogenital Distress Inventory (UDI-6) to assess their continence status preoperatively and postoperatively. Chi-squared, t, and Mann-Whitney U tests were used to determine the association between these data and anesthesia type during univariate analysis.


RESULTS
Both anesthesia groups showed significant improvement from their preoperative UDI-6 scores to their postoperative scores. However, when comparing the change from pre- to postoperative UDI-Stress Symptoms subscale scores between the 2 groups, we found a significant difference. Mean improvement in the local group was 58.3 (+/- 33.8) compared with 41.7 (+/- 39.4) in the general group (P = .02).


CONCLUSIONS
Women who undergo TVT show significant improvements in incontinence severity regardless of anesthesia type. However, greater improvements in stress incontinence, as measured by the UDI-Stress Symptoms subscale, are seen when the TVT is placed while using the cough-stress test under local analgesia.


METHODS
II-2.
Murphy
Miles
M
Health Sciences Center, University of Louisville, Louisville, Kentucky, USA. DrMurphy@fpminstitute.com
Culligan
Patrick J
PJ
Arce
Cristina M
CM
Graham
Carol A
CA
Blackwell
Linda
L
Heit
Michael H
MH
D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003371:Cough; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D011182:Postoperative Care; D011336:Probability; D011788:Quality of Life; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013526:Surgical Mesh; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000175:diagnosis* / Q000601:surgery*; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D014572:Urology / Q000379:methods