PURPOSE: The cure rate of tension-free vaginal tape (TVT) appeared to decrease overtime, with an associated increased in the stress urinary incontinence (SUI) recurrence rate.
We evaluated the long-term durability and functional outcomes of TVT and identified the risk factors that may affect recurrence.
METHODS: Eighty-eight patients, who were cured of SUI 6 months after undergoing TVT, were followed-up for at least 12 years. At post-operative, the patients were evaluated with a Severity Index for Urinary Incontinence questions regarding cure, patient's satisfaction, goal achievement, 3-day voiding diary with urinary urgency scale, uroflowmetry, and complications.
RESULTS: Cure rates decreased from 96.6 % at 1-year post-surgery to 83.0 % at 5 years and that the cure rates between 5 and 12 year were similar (83.0 vs. 79.6 %). Valsalva leak point pressure (VLPP) < 60 H2O was the only independent factor that predicted recurrence (p = 0.011; hazard radio 5.31). At last follow-up, 39.2 and 70.0 % of patients were free of urgency and urgency incontinence, respectively; and de novo urgency and urgency incontinence developed in 40.5 and 17.2 % of these patients, respectively. Age was the only factor that predicted freedom from overactive bladder (OAB) symptom. There was a significant reduction in the maximal flow rate from 23.3 ± 9.0 ml/s pre-operation to 18.8 ± 6.7 ml/s at 12 years post-operation.
CONCLUSIONS: TVT is an effective long-term treatment for SUI, although the cure rate may decrease with time. A low VLPP was predictive of SUI recurrence, and patients showing no OAB symptoms tended to be younger.
Written by:
Han JY, Park J, Choo MS. Are you the author?
Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea.
Reference: Int Urol Nephrol. 2014 Jun 18. Epub ahead of print.
doi: 10.1007/s11255-014-0759-1
PubMed Abstract
PMID: 24938694
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