title: Impact of tension-free vaginal tape procedure on dysfunctional voiding in women with stress urinary incontinence.
abstract: OBJECTIVE
  To determine the prevalence of dysfunctional voiding (DV) in female stress urinary incontinence (SUI) and its modification after tension-free vaginal tape (TVT) procedure.
  
  
  METHODS
  Three hundred and sixty women with SUI were enrolled and underwent urodynamics from 2002 to 2008. DV was determined when non-neurogenic detrusor-sphincter dyssynergia occurred during voluntary voiding. It was further quantitatively analyzed using the tense/loose value, a parameter derived from external anal sphincter electromyogram. The distribution of other urodynamic variables was also evaluated. One hundred and fifty patients underwent the TVT procedure and forty of them were studied with urodynamics after surgery during follow up.
  
  
  RESULTS
  Overall, DV was diagnosed in ninety-nine patients, with a prevalence of 27.5%. The functional profile length in SUI women with DV was significantly shorter than that in SUI women without DV (3.13 +/- 0.76 vs 3.32 +/- 0.65, P = 0.017). After the TVT procedure, the recovery of SUI between cases with and without DV showed no significant difference. The rate of DV state change after the surgery, namely from with to without DV or from without to with DV, significantly differed between the female patients with and without DV (66.7% vs 3.6%, P < 0.05) during follow up. The DV improved after the surgery in SUI women with DV.
  
  
  CONCLUSIONS
  DV might represent a coexistent finding in women with SUI. The main difference of women with SUI and DV, as compared with those without DV, is a shortened functional profile length. In such cases, TVT procedure can improve DV along with the treatment of SUI.
authors.affiliation: Department of Urology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Dan-Feng
authors.initials: DF
authors.lastname: Xu
authors.forename: Chuang-Yu
authors.initials: CY
authors.lastname: Qu
authors.forename: Ji-Zhong
authors.initials: JZ
authors.lastname: Ren
authors.forename: Hai-Hong
authors.initials: HH
authors.lastname: Jiang
authors.forename: Ya-Cheng
authors.initials: YC
authors.lastname: Yao
authors.forename: Zhi-Lian
authors.initials: ZL
authors.lastname: Min
authors.forename: You-Hua
authors.initials: YH
authors.lastname: Zhu
authors.forename: Lv
authors.initials: L
authors.lastname: Chao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D053825:Suburethral Slings; D014550:Urinary Incontinence, Stress / Q000503:physiopathology* / Q000601:surgery; D014554:Urination; D014563:Urodynamics; D055815:Young Adult