Tension-free vaginal tape for elderly women with stress urinary incontinence.
OBJECTIVE
To investigate the efficacy of the tension-free vaginal tape (TVT) procedure for the management of stress urinary incontinence (SUI) in elderly women.


METHODS
A total of 55 women aged between 65 and 86 years underwent a TVT procedure for urodynamic SUI. Of these, 15 (27%) had undergone previous surgery for treatment of SUI. Before the TVT procedure, a complete medical history was taken and a gynecologic examination performed.


RESULTS
Operating time ranged between 11 and 35 min (excluding the time of concomitant surgery, if any); hospitalization time ranged between 1 and 5 days; and no severe intraoperative or postoperative complications occurred. Cure occurred in 39 (76%) of 51 evaluable patients and its rate was positively associated with bladder neck mobility. Among patients in whom the angle of displacement on the Q-tip test was less than 30 degrees , 42% became continent whereas among those in whom it was 30 degrees or higher, 90% became continent (P<.001). Among those in whom the angle was between 20 degrees and 30 degrees, 57% became continent, and among those in whom it was less than 10 degrees, 80% remained incontinent.


CONCLUSIONS
The TVT procedure in elderly women with SUI offers a satisfactory cure rate; however, in patients with significantly decreased bladder neck mobility (an angle <20 degrees on the Q-tip test), the results are not encouraging.
Liapis
A
A
Second Department of Obstetrics and Gynecology, Aretaieio Hospital, University of Athens, Greece. eurotas@panafonet.gr
Bakas
P
P
Christopoulos
P
P
Giner
M
M
Creatsas
G
G
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007902:Length of Stay; D008487:Medical History Taking; D017060:Patient Satisfaction; D053825:Suburethral Slings; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*; D014621:Vagina / Q000601:surgery*