Early outcomes of mid-urethral slings for female stress urinary incontinence stratified by valsalva leak point pressure.
OBJECTIVE
To assess the early results of mid-urethral slings placed via the transobturator approach (TVT-O) for stress urinary incontinence (SUI) in women with high (>60 cm H(2)O) and low (<or=60 cm H(2)O) valsalva leak point pressure (VLPP).


METHODS
Forty-three women with urodynamically proven SUI underwent TVT-O. Patients were divided into either high (>60 cm H(2)O) or low (<or=60 cm H(2)O) VLPP categories based on preoperative urodynamic studies. Patient outcomes were assessed based on degree of postoperative SUI as either dry (no pads, no SUI), or wet (any leakage). Follow-up visits were at 1, 6, 12, and 24 weeks.


RESULTS
Overall, 65% (28/43) women were cured following TVT-O for SUI. When stratified based on preoperative VLPP, 77% (24/31) of patients with VLPP greater than 60 were cured while only 25% (3/12) of patients with VLPP less than or equal to 60 were cured. No intraoperative complications were noted. The odds of continued SUI following TVT-O were 12 times greater for women with VLPP <or=60 compared to those with VLPP >60.


CONCLUSIONS
With limited follow up, TVT-O appears to be a safe and effective surgical treatment for female SUI producing excellent results in patients with VLPP >60 cm/H(2)0. Patients with low VLPP may consider conventional, retropubic mid-urethral slings or other procedures as treatment for SUI.
O'Connor
R Corey
RC
Department of Urology, University of California Davis Medical Center, Sacramento, California 95817, USA.
Nanigian
Dana K
DK
Lyon
Mark B
MB
Ellison
Lars M
LM
Bales
Gregory T
GT
Stone
Anthony R
AR
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D011312:Pressure; D012189:Retrospective Studies; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014563:Urodynamics / Q000502:physiology; D013520:Urologic Surgical Procedures; D014636:Valsalva Maneuver / Q000502:physiology*