title: Identification of risk factors for voiding dysfunction following TVT placement.
abstract: OBJECTIVE
  To determine preoperative risk factors of postoperative voiding dysfunction after tension-free vaginal tape (TVT) procedure.
  
  
  METHODS
  In 2004, 100 patients with genuine stress urinary incontinence underwent surgery by the TVT procedure. Preoperative and postoperative urodynamic study was performed for each patient. Postoperatively, patients' perception of result and quality of life were assessed on two validated scales, namely, Mesure du Handicap Urinaire (MHU) and Ditrovie. Voiding dysfunction was defined by a postoperative peak flow rate of <15 ml/s at 3 mo. Clinical and urodynamic parameters were compared and analysed.
  
  
  RESULTS
  At 3 mo, 20 patients (20%) showed evidence of voiding dysfunction despite the absence of clinical symptoms in 14 of them (70%). Multivariate analysis showed that age (p<0.038) and preoperative peak flow rate (p<0.001) were independent risk factors for voiding dysfunction. Parity, menopausal status, body mass index, and maximal urethral closure pressure were not statistically related to the risk of voiding dysfunction.
  
  
  CONCLUSIONS
  This study confirms the existence of an important rate of postoperative voiding dysfunction, mostly asymptomatic, and identifies age and preoperative maximal peak flow rate as independent preoperative risk factors. Identification of voiding dysfunction in patients may lead to better follow-up and early detection of late potential complications of suburethral procedures.
authors.affiliation: Université Paris-Descartes, Faculté de Médecine, AP-HP, Hôpital Cochin, Department of Urology, Paris, France.
authors.forename: Ambroise
authors.initials: A
authors.lastname: Salin
authors.forename: Sophie
authors.initials: S
authors.lastname: Conquy
authors.forename: Caroline
authors.initials: C
authors.lastname: Elie
authors.forename: Cyril
authors.initials: C
authors.lastname: Touboul
authors.forename: Jérome
authors.initials: J
authors.lastname: Parra
authors.forename: Marc
authors.initials: M
authors.lastname: Zerbib
authors.forename: Bernard
authors.initials: B
authors.lastname: Debré
authors.forename: Delphine
authors.initials: D
authors.lastname: Amsellem-Ouazana
mesh_terms: D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D053825:Suburethral Slings / Q000009:adverse effects*; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014555:Urination Disorders / Q000453:epidemiology / Q000209:etiology*