title: Long-term clinical outcomes of the tension-free vaginal tape procedure for the treatment of stress urinary incontinence in elderly women over 65.
abstract: OBJECTIVE
  The aim of this study was to assess the long-term clinical outcomes of the tension-free vaginal tape (TVT) procedure for stress urinary incontinence (SUI) in elderly women and to identify the factors influencing failure in these cases.
  
  
  METHODS
  Women with SUI who underwent a TVT procedure were studied. "Cure" was defined as no urine leakage at all in any circumstances and "improvement" was defined as some urine leakage but a score of over 4 points out of 5 in a satisfaction inquiry. Patients were divided into two groups (middle-aged, <65 years and elderly, ≥65 years) for comparison of clinical outcomes. In the elderly group, patients were subdivided into two groups (cure and no cure groups) and were compared to identify the factors influencing failure.
  
  
  RESULTS
  A total of 136 women (middle-aged group, 106; elderly group, 30) were enrolled in the study. The mean ages of the patients in the 2 groups were 53.5±5.9 and 72.0±5.0 years and the mean follow-up times were 50.5±9.4 and 48.8±9.1 months, respectively. The cure and improvement rates in the middle-aged and elderly groups were 80.2% vs. 66.7% and 4.7% vs. 3.3%, respectively (p>0.05). The satisfaction scores in the middle-aged and elderly groups were 3.8±1.1 vs. 3.3±1.5 points (p>0.05). In the elderly group, the body mass index of the cure and no cure groups were 24.6±3.3 kg/m(2) and 26.6±1.0 kg/m², and body mass index was the only factor that differed significantly between the two subgroups (p=0.028).
  
  
  CONCLUSIONS
  Our long-term results suggest that TVT is an effective treatment even in elderly women. However, elderly women who are obese should be counseled carefully about the success rate.
authors.affiliation: Department of Urology, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Kyung Kyu
authors.initials: KK
authors.lastname: Jun
authors.forename: Su Min
authors.initials: SM
authors.lastname: Oh
authors.forename: Gwoan Youb
authors.initials: GY
authors.lastname: Choo
authors.forename: Hyoung Keun
authors.initials: HK
authors.lastname: Park
authors.forename: Sung Hyun
authors.initials: SH
authors.lastname: Paick
authors.forename: Yong Soo
authors.initials: YS
authors.lastname: Lho
authors.forename: Hyeong Gon
authors.initials: HG
authors.lastname: Kim