title: TVT for the treatment of urodynamic stress incontinence: Efficacy and adverse effects at 13-year follow-up.
abstract: To assess long-term subjective, objective, and urodynamic outcomes of retropubic mid-urethral slings at 13-year follow-up.
  
  
  
  This was a prospective observational study. Consecutive women with proven urodynamic stress incontinence were treated with standard retropubic tension free vaginal tape (TVT). Patients with mixed incontinence and/or anatomic evidence of pelvic organ prolapse were excluded. All the included patients underwent preoperative clinical and urodynamic evaluations. During follow-up examinations, women were assessed for subjective satisfaction and objective cure rates. The Cox model was used in order to investigate factors predicting the risk of recurrent stress urinary incontinence (SUI), over the study period.
  
  
  
  Overall, 55 patients were suitable for the analysis. At 13-year follow-up, 47 out of 55 (85.5%) patients declared themselves cured (p-for-trend 0.02) and 48 out of 58 (87.2%) were at least improved (p-for-trend 0.07). No significant deterioration of objective cure rates was observed over time (P = 0.29). At the time of the last evaluation, 50 out of 55 (90.9%) women were objectively cured; urodynamic evaluation confirmed this finding in 49 (89.1%) patients. Considering factors predictive of SUI recurrence, we observed that, via multivariate analysis, obesity (HR 7.2; P = 0.01) and maximum detrusor pressure during the voiding phase ≤29 cmH2O (HR 8.0; P = 0.01) were the only independent predictors of recurrent SUI.
  
  
  
  Our data confirmed that TVT is a highly effective and safe procedure also at 13-year follow-up. Interestingly, we observed a significant decrease of subjective satisfaction over time. Neurourol. Urodynam. 36:192-197, 2017. © 2015 Wiley Periodicals, Inc.
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Serati
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Sorice
authors.affiliation: Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bogani
authors.affiliation: Eoc-Ente Ospedaliero Cantonale, Obv-Ospedale Beata Vergine, Mendrisio, Svizzera.
authors.forename: Andrea
authors.initials: A
authors.lastname: Braga
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Cantaluppi
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Uccella
authors.affiliation: Eoc-Ente Ospedaliero Cantonale, Obv-Ospedale Beata Vergine, Mendrisio, Svizzera.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Caccia
authors.affiliation: Department of Obstetrics and Gynaecology, Vita-Salute San Raffaele University and IRRCS San Raffaele Hospital, Milan, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Salvatore
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Ghezzi
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D053825:Suburethral Slings / Q000009:adverse effects; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000503:physiopathology; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000628:therapy*; D014563:Urodynamics
keywords: long term follow-up; mid-urethral sling; stress urinary incontinence (SUI); tension-free vaginal tape (TVT); urodynamic stress incontinence (USI)