title: Influence of TVT properties on outcomes of midurethral sling procedures: high-stiffness versus low-stiffness tape.
abstract: OBJECTIVE
  Although there is clear consensus on the use of monofilament polypropylene tapes for treating stress urinary incontinence (SUI), tapes differ in weight, stiffness, and elasticity. In this study, we compared outcomes of two tape types: high-stiffness Intramesh SOFT L.I.F.T versus low-stiffness Intramesh L.I.F.T. tape. Our null hypothesis was that in terms of performance, SOFT tape equaled L.I.F.T. tape.
  
  
  METHODS
  Six hundred and sixty women underwent prospective transvaginal tape (TVT) surgery for SUI: 210 had the SOFT tape placed and 450 the L.I.F.T. tape. Follow-ups were scheduled at 3 and 12 months.
  
  
  RESULTS
  Objective cure at 3-months' follow-up was 87 % in the SOFT group vs 94 % in the L.I.F.T. group (p = 0.003) and at 12 months 86 vs 96 % (p = 0.0004), respectively. Subjective outcomes were equal. For SOFT tape, the objective failure rate at 3 months was especially pronounced in women older than 70 years: 31 vs 10 % (p = 0.008), and subjective failure was 24 vs 7 % (p = 0.01). At 12 months, objective failure for the SOFT tape was significantly higher in both age groups compared with L.I.F.T. [odds ratio (OR) 2.17]. Multivariate analysis showed that body mass index (BMI) ≥30 (OR 2.41), mixed incontinence (MUI) (OR 2.24), use of SOFT tape (OR 2.17), and age ≥ 70 years are significant independent risk factors for surgical failure.
  
  
  CONCLUSIONS
  Outcomes with SOFT tape are significantly inferior than with L.I.F.T. tape, especially among elderly women. Therefore, the two variants of monofilament polypropylene tape are not interchangeable.
authors.affiliation: Department of Obstetrics and Gynecology, Nykøbing Falster Hospital, Fjordvej 15, DK-4800, Nykøbing Falster, Denmark. jcpr@regionsjaelland.dk.
authors.forename: Jens Christian
authors.initials: JC
authors.lastname: Prien-Larsen
authors.affiliation: Department of Obstetrics and Gynecology, Nykøbing Falster Hospital, Fjordvej 15, DK-4800, Nykøbing Falster, Denmark.
authors.forename: Thomas
authors.initials: T
authors.lastname: Prien-Larsen
authors.affiliation: Department of Obstetrics and Gynecology, Nykøbing Falster Hospital, Fjordvej 15, DK-4800, Nykøbing Falster, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Cieslak
authors.affiliation: Department of Clinical Microbiology, Slagelse Hospital, DK-4200, Slagelse, Denmark.
authors.forename: Ram B
authors.initials: RB
authors.lastname: Dessau
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D013509:Gynecologic Surgical Procedures / Q000295:instrumentation* / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D053825:Suburethral Slings / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*
keywords: High-stiffness; Low-stiffness; Low-weight tape; Mixed urinary incontinence; Stress urinary incontinence; TVT