title: Is the adjustable TVA mesh effective for the long-term treatment of female stress incontinence?
abstract: OBJECTIVE
  To assess the long-term safety and efficacy of the adjustable TVA mesh in treating stress urinary incontinence.
  
  
  METHODS
  Pseudoexperimental study, before and after, conducted in a university urology department. Eighty-two patients were invited to participate from January 2002 to March 2005. Thirty-two patients agreed to participate and were implanted an adjustable TVA mesh. The preoperative study included a medical history review, physical examination with full bladder, flowmetry, residue study, complete urodynamic study and the self-administered questionnaires I-QoL and ICIQ-SF. In the postoperative assessment, the PGI-I questionnaire was added, but a complete urodynamic study was not performed.
  
  
  RESULTS
  Twenty-nine (90.6%) and 28 (87.5%) patients were continent in the stress test at 1 and 10 years, respectively. Twenty (62.5%) and 16 (50%) patients had no urine escape at 1 and 10 years, respectively. Twenty-eight (87.5%) and 25 (78%) patients were satisfied 1 and 10 years after the surgery, respectively. Twenty-eight (87.5%) and 21 (62.5%) patients had a good quality of life at 1 year and at 10 years, respectively. There were no significant complications at the end of the study period.
  
  
  CONCLUSIONS
  Treatment of stress urinary incontinence with the TVA mesh presented a high degree of objective healing and satisfaction at 10 years, with no severe adverse effects. The study showed that satisfaction does not always mean total continence but rather it reflects the improvement of symptoms and consequent quality of life.
authors: Servicio de Urología, Hospital Universitario San Juan, San Juan de Alicante, Alicante, España. Electronic address: jromeroma@coma.es.
authors: J
authors: J
authors: Romero-Maroto
authors: Servicio de Urología, Hospital Universitario San Juan, San Juan de Alicante, Alicante, España.
authors: H
authors: H
authors: Pérez-Seoane
authors: Servicio de Urología, Hospital Universitario San Juan, San Juan de Alicante, Alicante, España.
authors: L
authors: L
authors: Gómez-Perez
authors: Servicio de Urología, Hospital Universitario San Juan, San Juan de Alicante, Alicante, España.
authors: C
authors: C
authors: Pérez-Tomás
authors: Servicio de Urología, Hospital Universitario San Juan, San Juan de Alicante, Alicante, España.
authors: J J
authors: JJ
authors: Pacheco-Bru
authors: Servicio de Urología, Hospital Universitario San Juan, San Juan de Alicante, Alicante, España.
authors: A
authors: A
authors: López-López
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D011474:Prosthesis Design; D011788:Quality of Life; D053825:Suburethral Slings; D013526:Surgical Mesh; D013997:Time Factors; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*
keywords: Adjustable suburethral mesh; Complicaciones quirúrgicas; Incontinencia urinaria de esfuerzo; Malla suburetral ajustable; Resultados; Results; Stress urinary incontinence; Surgical complications