A multicenter, prospective, randomized clinical trial comparing tension‐free vaginal tape surgery and no treatment for the management of stress urinary incontinence in elderly women

Abstract

At 6 months post-randomization, the group of elderly women who underwent immediate TVT surgery showed a significant improvement in QOL, patient satisfaction and less urinary problems compared to the group of women waiting for the same surgery.

Surgery for urinary incontinence in women 65 years and older: a systematic review

“…1) [9][10][11][12][13][14][15][16][17]. Four of those were not included in the analysis because of the high risk of bias (low study quality) [10,13,15,17].…”

“…This was due to small populations, the lack of description of those lost to follow-up and/or lack of a control group. Five studies-all evaluating the suburethral sling procedure-were considered to be of moderate quality and were further included (Table 1) [9,11,12,14,16].…”

“…2 The presence of de novo urge, remaining stress urinary incontinence (SUI) or urge urinary incontinence (UUI) in elderly women compared with younger women after tension-free vaginal tape (TVT) operation/surgery [9]. Three studies had each a control group comprising younger people (Table 1) [11,12,14] (1 was a case control study and 2 were NRS).…”

Is there a learning curve for the TVT-O procedure? A prospective single-surgeon study of 372 consecutive cases

“…Objective cure was defined as the absence of urine leakage during the stress test. To define the subjective outcomes at 1 year, all patients completed the ICIQ-sf, the Patient Global Impression-Global Improvement (PGI-I) Scale (a 7-point scale, with a range of responses from 1 ''very much improved'' through 7 ''very much worse'') [17], the Patient Satisfaction Scale (a single self-answered Likert-type scale of 0-10 which grades the patient's degree of satisfaction regarding continence (0 represents ''not satisfied,'' and 10, ''satisfied'') [18] and the Urinary Distress Inventory (UDI), the urinary subscale of the Pelvic Floor Distress Inventory (PFDI) [19]. To quantify groin pain, all patients completed at 1 day, 2 days and 1, 3 and 12 months, a single self-answered VAS scale of 0-10.…”

Recent advances in the treatment of urinary incontinence in older women

“…Unsurprisingly, older age and comorbidity were associated with greater risk of postsurgical complications [42 ]; however, older women do benefit. In a study of immediate versus delayed tension free vaginal tape in older women, and of general incontinence procedures in women over 60, significant improvement in quality of life has been described [43,44 ]. Surgery aimed at the correction of pelvic organ prolapse has also been shown to reduce overactive bladder symptoms in elderly women [45].…”