title: Five-year outcomes of the tension-free vaginal tape procedure for treatment of female stress urinary incontinence.
abstract: OBJECTIVE
  We evaluated the long-term efficacy and safety of a tension-free vaginal tape (TVT) procedure for the treatment of female stress urinary incontinence (SUI) in a Korean population.
  
  
  METHODS
  We included 134 patients (mean age, 52.3+/-9.3 yr) who underwent the TVT procedure for SUI in three institutions and followed for 5 yr (mean, 67.0 mo; range, 60-76 mo) postoperatively. We analysed voiding diaries and complete multichannel urodynamic studies preoperatively as well as cough stress tests, uroflowmetry, and questionnaires postoperatively.
  
  
  RESULTS
  The overall 5-yr success rates (cure/improved) were 94.9% (76.9% and 18.0%, respectively), with an 86.6% patient satisfaction rate. Although the success rates between 1 and 5 yr were similar (97.7% vs. 94.9%), the cure rate decreased from 90.1% to 76.9% (p<0.001) at 5 yr. The 5-yr cure rate for mixed urinary incontinence (MUI) was 72.0%, which was not significantly different from pure SUI (78.0%, p>0.05). Maximal flow rate dropped from 25.9+/-10.3ml/s to 20.4+/-8.6ml/s at 1 mo postoperatively and recovered to 24.8+/-8.5ml/s at 5 yr. Complications included bladder perforation in 5 patients (3.7%), tape cutting or release in 11 (8.2%), and persistent suprapubic pain in 3 (2.2%). Urgency and urge incontinence improved in 46.7% and 48.0% of patients, respectively.
  
  
  CONCLUSIONS
  TVT was an effective and safe procedure for SUI and MUI with high success rates in the long-term follow-up. It also improved concomitant overactive bladder symptoms and initially reduced postoperative urine flow, which recovered over time.
authors.affiliation: Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Chin Kyung
authors.initials: CK
authors.lastname: Doo
authors.forename: Bumsik
authors.initials: B
authors.lastname: Hong
authors.forename: Byung Joo
authors.initials: BJ
authors.lastname: Chung
authors.forename: Ji Yoon
authors.initials: JY
authors.lastname: Kim
authors.forename: Hee Chang
authors.initials: HC
authors.lastname: Jung
authors.forename: Kyu-Sung
authors.initials: KS
authors.lastname: Lee
authors.forename: Myung-Soo
authors.initials: MS
authors.lastname: Choo
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007723:Korea; D008875:Middle Aged; D011183:Postoperative Complications; D053825:Suburethral Slings; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014563:Urodynamics