title: Efficacy of TVT-SECUR and factors affecting cure of female stress urinary incontinence: 3-year follow-up.
abstract: OBJECTIVE
  The aim of this study was to evaluate the efficacy of the TVT-SECUR procedure for treating stress urinary incontinence (SUI) and to identify factors affecting cure during 3 years of follow-up.
  
  
  METHODS
  We prospectively followed patients until 1 year postoperatively and contacted them to revisit the clinic at 3 years. Ninety-six women who underwent TVT-SECUR (H type: 42, U type: 54) were followed up for at least 3 years. Patients were evaluated using the Severity Index for Urinary Incontinence, the Incontinence Quality of Life questionnaire, and the Bristol Female Lower Urinary Tract Symptom-Short Form questionnaire at baseline and at each postoperative visit. Patient satisfaction and complications were evaluated. Surgical outcome was assessed according to the Severity Index for Urinary Incontinence. Multivariate regression analysis was used to identify preoperative factors independently associated with cure.
  
  
  RESULTS
  The 3-year success rate was 91.7 % (cure 72.9 %, improved 18.8 %). The success rate was maintained from 94.8 % at 1 year to 91.7 % at 3 years, but the cure rate decreased significantly from 85.4 % at 1 year to 72.9 % at 3 years. Patient satisfaction rate was 85.4 %. Cure rates were lower in patients with Valsalva leak point pressure (VLPP) <60 cmH(2)O (79.5 % vs. 52.2 %, p = 0.010). Multivariate analysis showed that only low VLPP was associated with a lower cure rate.
  
  
  CONCLUSIONS
  The cure rate of female SUI after the TVT-SECUR procedure was not sustained, but the overall success rate was maintained over time. Low VLPP predicted failure to sustain cure.
authors.affiliation: Department of Urology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, 20 Geumo-ro, Mulgeum-eup, Yangsan, Gyeongnam 626-770, Korea.
authors.forename: Ji-Yeon
authors.initials: JY
authors.lastname: Han
authors.forename: Junsoo
authors.initials: J
authors.lastname: Park
authors.forename: Myung-Soo
authors.initials: MS
authors.lastname: Choo
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D053825:Suburethral Slings; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics