SUBJECTIVE CURE RATES AFTER TVT PROCEDURE FOR TREATMENT OF FEMALE URINARY INCONTINENCE – A QUESTIONNAIRE BASED STUDY
Keywords:
urinary incontinence, tenson-free vaginal tape, treatmentAbstract
Background. The aim of this study was to assess the subjective cure rate after the tension-free vaginal tape (TVT) procedure in patients with stress (SUI) and mixed (MUI) urinary incontinence.
Methods. This is a questionnaire based study done in 43 patients with SUI and 52 patients with MUI. In the assessement of the subjective cure rate the visual analogue scale and the symptom assessment index (SAI) were used. Data were analyzed using nonparametric statistics.
Results. The subjective cure rate assessed 19.6 months after TVT amounted to 89.3%. Urinary incontinence after TVT procedure was noted in 26 patients (27.4%) and the majority of these women (73.1%) were diagnosed with MUI. In patients with SUI and postoperative stable bladder a higher success rate was observed (96.7%). In 18.6% patients with SUI, de novo overactive bladder symptoms occurred. These patients estimated a significantly (p = 0.027) lower cure rate (81.9%) after TVT procedure. In patients with MUI, the cure rate after TVT amounted to 85.6%. The subjective cure rate was lower (79.4%) in case of persistent overactive bladder symptoms. However, it was significantly higher (97.5%) in case of a postoperatively stable bladder (p = 0.016). In the group of MUI patients, the symptoms of overactive bladder disease resolved spontaneously in 17 patients (32.7%) postoperatively. The patients were satisfied with TVT and 92.6% would recommend this procedure to others.
Conclusions. The TVT procedure is a very effective method of treatment for stress as well as mixed urinary incontinence. The success rate of the procedure is high, however, it is influenced by bladder activity.
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References
Temml C, Haidinger G, Schmidbauer J, Schatzl G, Madersbacher S. Urinary incontinence in both sexes: prevalence rates and impact on quality of life and sexual life. Neurourol Urodyn 2000; 19: 259–71.
Hampel C, Wienhold D, Benken N, Eggersmann C, Thüroff JW. Prevalence and natural history of female incontinence. Eur Urol 1997; 32: 3–12.
Leach GE, Dmochowski RR, Appell RA et al. Female stress urinary incontinence: clinical guidelines panel summary report on surgical management of female stress urinary incontinence. J Urol 1997; 158: 875–80.
Ulmsten U, Henriksson L, Johnson P, Varhos G. An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J 1996; 7: 81–6.
Jeffry L, Deval B, Birsan A, Soriano D, Darai E. Objective and subjective cure rates after tension-free vaginal tape for treatment of urinary incontinence. Urology 2001; 58: 702–6.
Deval B, Jeffry L, Najjar FA, Soriano D, Darai E. Determinants of patient dissatisfaction after a tension-free vaginal tape procedure for urinary incontinence. J Urol 2002; 167: 2093–7.
Klutke C, Siegel S, Carlin B, Paszkiewicz, Kirkemo A, Klutke J. Urinary retention after tension-free vaginal tape procedure: incidence and treatment. Urology 2001; 58: 697–701.
Rardin CR, Rosenblatt PL, Kohli N, Miklos JR, Heit M, Lucente VR. Release of tension-free vaginal tape for the treatment of refractory postoperative voiding dysfunction. Obstet Gynecol 2002; 100: 898–902.
Volkmer BG, Nesslauer T, Rinnab L, Schradin T, Hautman RE, Gottfried HW. Surgical intervention for complications of the tension-free vaginal tape procedure. J Urol 2003; 169: 570–4.
Kuuva N, Nilsson CG. A nationwide analysis of complications associated with the tension-free vaginal tape (TVT) procedure. Acta Obstet Gynecol Scand 2002; 81: 72–7.
Nilsson CG, Kuuva N. The tension-free vaginal tape procedure is successful in the majority of women with indications for surgical treatment of urinary stress incontinence. BJOG 2001; 108: 414–9.
Vierhout ME, Mulder AF. De novo detrusor instability after Burch colposuspension. Acta Obstet Gynecol Scand 1992; 71: 414–6.
Bombieri L, Freeman RM, Perkins EP, Williams MP, Shaw SR. Objective assessment of bladder neck elevation and urethral compression at colposuspension. BJOG 2002; 109: 395–401.
Falconer C, Ekman-Ordeberg G, Malmstrom A, Ulmsten U. Clinical outcome and changes in connective tissue metabolism after intravaginal slingplasty in stress incontinent women. Int Urogynecol J Pelvic Floor Dysfunct 1996; 7: 133–7.
De Muylder X, Claes H, Neven P, De Jaegher K. Usefulness of urodynamic investigations in female incontinence. Eur J Obstet Gynecol Reprod Biol 1992; 13: 205–8.
van Waalwijk van Doorn ES, Remmers A, Janknegt RA. Conventional and extramural ambulatory urodynamic testing of the lower urinary tract in female volunteers. J Urol 1992;147: 1319–25.
Heslington K, Hilton P. Ambulatory monitoring and conventional cystometry in asymptomatic female volunteers. Br J Obstet Gynecol 1996; 103: 434–41.
Meschia M, Pifarotti P, Bernasconi E et al. Tension-free vaginal tape: analysis of outcomes and complications in 404 stress incontinent women. Int Urogynecol J 2001; 2: 24–7.
Rezapour M, Ulmsten U. Tension-Free vaginal tape (TVT) in women with mixed urinary incontinence—a long-term follow-up. Int Urogynecol J Pelvic Floor Dysfunct 2001; 12: 15–8.
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