Identification of risk factors for voiding dysfunction following TVT placement.
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.
Salin
Ambroise
A
Université Paris-Descartes, Faculté de Médecine, AP-HP, Hôpital Cochin, Department of Urology, Paris, France.
Conquy
Sophie
S
Elie
Caroline
C
Touboul
Cyril
C
Parra
Jérome
J
Zerbib
Marc
M
Debré
Bernard
B
Amsellem-Ouazana
Delphine
D
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*