Tension-free vaginal tape (TVT) for treatment of stress urinary incontinence in women with low-pressure urethra.
OBJECTIVE
To assess the results of TVT in patients with urinary stress incontinence, urethral hypermobility, and low-pressure urethra.


METHODS
We retrospectively analysed 265 consecutive women who underwent a TVT procedure for urodynamic stress urinary incontinence over a 31-month period. Women were divided into two groups depending on their preoperative maximum urethral closure pressure (MUCP). Group 1 (61 women with MUCP<or=20 cm H2O) were compared with 204 women (group 2) with a MUCP>20 cm H2O. Subjective and objective outcome data were assessed from routine postoperative visits. Office and hospital records were reviewed to check patients' characteristics, intraoperative findings, and surgical outcomes.


RESULTS
Women with low-pressure urethra were older than those with MUCP>20 cm H2O; they were more likely to have had a hysterectomy or anti-incontinence surgery. The mean duration of follow-up was 31 (+/-11) months. Cure rates among patients with low- or normal-pressure urethra were similar (77% and 86%, P=0.70). Nevertheless, the former were more likely to complain of voiding dysfunction.


CONCLUSIONS
TVT is a highly effective treatment even in women with intrinsic sphincter deficiency.
Meschia
Michele
M
Department of Obstetrics and Gynecology, Ospedale "G. Fornaroli", Via Al Donatore di Sangue 52, 20013 Magenta, Milano, Italy. m.meschia@libero.it
Pifarotti
Paola
P
Buonaguidi
Arturo
A
Gattei
Umberto
U
Spennacchio
Maurizio
M
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome; D014521:Urethra / Q000503:physiopathology*; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics; D013520:Urologic Surgical Procedures; D014621:Vagina / Q000601:surgery*