Tension-free vaginal tape - a suitable procedure for patients with recurrent stress urinary incontinence.
OBJECTIVE
To evaluate the efficacy of the tension-free vaginal tape operation (TVT) in patients with and without previous anti-incontinence surgery.


METHODS
Prospective follow-up study.


METHODS
University hospital in Finland.


METHODS
A total of 130 women who had a TVT procedure from August 1998 to December 2002.


METHODS
Subjective cure, complications and voiding symptoms.


METHODS
Sixty women with recurrent (group A) and 70 women with primary stress urinary incontinence (SUI) (group B) were compared. One follow-up visit took place two months postoperatively and a questionnaire-based evaluation was carried out three years after operation. Further information was collected a mean of eight years after the operation.


RESULTS
There was no difference in the transient postoperative retention rate (17 vs. 19%, p = 0.78) and number of complications (20 vs. 13%, p = 0.29) between group A and group B. At two months after operation, 85% of patients in group A and 94% in group B were cured of SUI and were satisfied with the operative result (p = 0.096). The satisfaction rates at three years were 86 and 91% in groups A and B, respectively, and cure rate of SUI was 93% in both groups. At follow-up, 20% of the patients in group A and 5.7% in group B (p = 0.013) had de novo urge symptoms and the rate of voiding difficulties increased especially in group B women over time.


CONCLUSIONS
TVT results in the same cure and complication rates when performed for primary SUI and recurrent SUI. The procedure is effective and associated with a low and acceptable level of complications. It is well suited to treat also recurrent SUI.
Ala-Nissilä
Seija
S
Department of Obstetrics and Gynecology, University of Turku, FIN-20520 Turku, Finland. seija.ala-nissila@tyks.fi
Haarala
Mervi
M
Mäkinen
Juha
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011183:Postoperative Complications; D011446:Prospective Studies; D012008:Recurrence; D012086:Reoperation; D053825:Suburethral Slings; D014550:Urinary Incontinence, Stress / Q000601:surgery*
D018680:Cholinergic Antagonists