To evaluate the long-term safety and efficacy of inside-out transobturator tape (tension-free vaginal tape-obturator, TVT-O) for the treatment of stress urinary incontinence (SUI).
Between August 2004 and August 2006, 87 consecutive SUI patients who underwent TVT-O were enrolled in this prospective cohort study. Patients with mixed incontinence, or pelvic organ prolapse requiring surgery, were excluded. Data relating to long-term postoperative complications, subjective satisfaction rate (Patient Global Impression of Improvement), objective cure rate (stress test), quality of life and sexual function were collected during follow-up. The Incontinence Impact Questionnaire (IIQ-7) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) were used to assess quality of life and sexual function, respectively. Statistical analyses were performed using paired-sample t-tests.
At 12-year follow-up, 73 patients (84%) were available for evaluation. Overall, the long-term complication rate was 45.2%. De novo overactive bladder was observed in 12.3% of patients. None of the patients reported severe voiding dysfunction that need required treatment of tape removal or catheterization. However, 16 patients (16/73, 21.9%) had voiding changes compared with their preoperative status. Persistent groin pain was seen in 1.4% of patients, and tape exposure occurred in 5.5% of patients. The subjective satisfaction rate and objective cure rate were 80.8% and 82.2%, respectively. Compared with preoperative scores, the IIQ-7 score decreased significantly (P<0.05), while no significant difference was noted in the PISQ-12 score (P=0.893).
This 12-year follow-up study showed that TVT-O is a highly effective procedure for the treatment of SUI. Long-term complication rate appears to be slightly high, which should raise concern. This article is protected by copyright. All rights reserved.
BJU international. 2018 Sep 24 [Epub ahead of print]
Ye Zhang, Xiaochen Song, Zhibo Zhang, Meng Mao, Fangfang Ai, Jia Kang, Lan Zhu
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital Chinese Academy of Medical Sciences.