[Placement of tension-free vaginal tape in women with stress urinary incontinence: Long-term functional outcomes in a prospective series]

Prog Urol. 2017 Oct;27(12):640-646. doi: 10.1016/j.purol.2017.05.009. Epub 2017 Jun 23.
[Article in French]

Abstract

Purpose: To evaluate the long-term functional outcomes after retropubic tension-free vaginal tape (TVT) placement to treat female stress urinary incontinence (SUI).

Methods: From September 1998 to September 2000, we prospectively enrolled all consecutive women in our center suffering SUI caused by urethral hypermobility. All women had a retropubic TVT inserted by the same surgeon. Patients were evaluated at 1, 3, 6 and 12 months postoperatively, and annually thereafter. Postoperative assessment included a measurement of post-voiding residual volume, urinalysis, a 1-hour pad test, a urinary symptom questionnaire, and an assessment of quality-of-life. Objective continence (defined as no urine leakage at clinical examination) and subjective continence (defined as no urine leakage, whatever the mechanism, reported by the patient) were reported.

Results: Overall, 58 consecutive women (median age 59; IQR 49-67; min 21-max 78) were evaluated. Median follow-up was 10.2years (IQR 1.4-16.0; min 1-max 13.2). At the last follow-up, objective and subjective continence rates were 93% and 78%, respectively and remained stable in the long run. Pad tests, urinary symptom questionnaire scores and quality-of-life were significantly improved. Self-intermittent catheterisation was required by three women. A section of one TVT and removal of another tape was undertaken in two women with chronic pelvic pain. One patient had a chronic urinary infection. Rate of de novo urgency was 10%.

Conclusions: TVT implantation offered good and stable functional long-term outcomes. This procedure enhanced quality-of-life and had low morbidity.

Level of evidence: 3.

Keywords: Bandelette sous-urétrale rétropubienne; Female; Femme; Incontinence urinaire d’effort; Stress urinary incontinence; Suburethral sling; TVT.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Middle Aged
  • Prospective Studies
  • Recovery of Function
  • Suburethral Slings*
  • Time Factors
  • Treatment Outcome
  • Urinary Incontinence, Stress / surgery*
  • Young Adult