title: Analysis of risk factors associated with surgical failure of inside-out transobturator vaginal tape for treating urodynamic stress incontinence.
abstract: The goals of this study were to assess the efficacy of inside-out transobturator vaginal tape (TVT-O) as a treatment of urodynamic stress incontinence (USI) and to explore the possible factors determining surgical success and failure. Each woman had a 20-min pad test and urodynamic study including uroflowmetry, cystometry, and stress urethral pressure profile before and after treatment. Forty-six of the 54 women (85%) were cured of the disease, and two (4%) showed clinical improvement; TVT-O had failed to treat USI in six patients (11%) during the 9-month follow-up period. We assessed the relationship between clinical features, urodynamic parameters, and treatment outcome. Of these, only age and previous anti-incontinence surgery were significant risk factors for surgical failure. The success rate during the 9-month follow-up period decreased significantly in women > or =60 years and in women with previous anti-incontinence surgery. Women with USI can be treated by the TVT-O procedure.
authors.affiliation: Department of Obstetrics and Gynecology, China Medical University Hospital, No. 2 Yu-Der Road, Taichung, 404, Taiwan, Republic of China. d888208@ms45.hinet.net
authors.forename: Huey-Yi
authors.initials: HY
authors.lastname: Chen
authors.forename: Lian-Shung
authors.initials: LS
authors.lastname: Yeh
authors.forename: Wei-Chun
authors.initials: WC
authors.lastname: Chang
authors.forename: Ming
authors.initials: M
authors.lastname: Ho
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D012086:Reoperation; D012307:Risk Factors; D053825:Suburethral Slings; D017211:Treatment Failure; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*