A three‐year follow up of tension free vaginal tape for surgical treatment of female stress urinary incontinence

Ulmsten, Ulf; Johnson, Per; Rezapour, Masoumeh

doi:10.1111/j.1471-0528.1999.tb08272.x

Cited by 536 publications

(390 citation statements)

References 13 publications

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“…Our results demonstrate an excellent outcome following this procedure, with complete correction of incontinence in 83.3% (n=10). A further 12,13 However this group of patients is di erent, as all patients had neuropathic bladders. In this series previous surgery for incontinence had neither any e ect on the outcome nor did it result in any serious complications, which is similar to a recently reported series.…”

Section: Discussionmentioning

confidence: 99%

“…The commonly reported complications have been bladder perforation with a rate up to 6%, 12 severe bleeding and obturator nerve injury. 17 We did encounter a single bladder perforation, which was immediately recognised intra-operatively and corrected by lateral repositioning of the introducer needle and extended urethral catheterization for 5 days postoperatively.…”

Section: Discussionmentioning

confidence: 99%

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Experience of tension-free vaginal tape for the treatment of stress incontinence in females with neuropathic bladders

Hamid

Khastgir

Arya³

et al. 2003

Spinal Cord

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Study design: Retrospective. Objective: To evaluate the safety and e cacy of the tension-free vaginal tape (TVT) for the treatment of stress incontinence in females with neuropathic bladders. Setting: London Spinal Injuries Unit, Stanmore & Institute of Urology, London, UK. Methods: Twelve women (mean age 53.3 years; range 41 ± 80 years) with neuropathic bladder dysfunction and stress urinary incontinence were treated with tension-free vaginal tape (TVT) between November 1997 and December 2000. The group consisted of women with: (i) traumatic spinal cord injuries (n=3); (ii) post lumbar spinal surgery (n=6); (iii) spinal stenosis (n=3). Four of the 12 patients had previously failed surgery for stress incontinence. All patients underwent pre-and post-TVT evaluation with video-urodynamic studies. Results: Mean follow-up was 27.1 months (range 17 ± 54 months). Three patients were voiding spontaneously (stress voiding) before surgery and continued to do so post-operatively. The remaining 9 were performing clean intermittent self-catheterisation before the insertion of TVT and continued to do so after the surgery. At follow up 10 patients (83.3%) were dry. The procedure failed in one patient and the other complained of mild leakage, but she reported a decrease in the number of pads used. One patient developed detrusor hyperre¯exia on postoperative video-urodynamics but there was no evidence of stress incontinence. One patient had a bladder perforation on insertion of TVT, managed successfully with extended use of a urethral catheter post-operatively. Three patients developed post-operative urinary tract infection successfully treated with oral antibiotics. Conclusions: Tension-free vaginal tape insertion is minimally invasive, safe and e ective for the treatment of stress incontinence in females with bladder neuropathy with intrinsic sphincter de®ciency. Previous surgery for incontinence did not a ect post-operative complications or outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Experience of tension-free vaginal tape for the treatment of stress incontinence in females with neuropathic bladders

Hamid

Khastgir

Arya³

et al. 2003

Spinal Cord

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“…minimal surgical trauma, shorter postoperative stay and the local anaesthetic technique which allows the patient to cough enabling accurate adjustment of the tape). In a three-year follow up study of 50 patients Ulmsten et al 3 reported an 86% complete cure rate with no intra-operative complications. However 10% of the patients needed an indwelling catheter temporarily.…”

Section: Introductionmentioning

confidence: 99%

Short term complications of the tension free vaginal tape operation for stress urinary incontinence in women

Bodelsson¹

2002

BJOG: An International Journal of Obstetrics and Gynaecology

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Objective To assess the prevalence of intra-and post-operative complications with the tension free vaginal tape operation for female urinary incontinence. Design Non-control case series.Setting University Hospital.Population One hundred and seventy-seven operations on women who were diagnosed urodynamically to have genuine stress incontinence. In 26 cases (15%) there was symptomatic urge incontinence. Main outcome measures Intra-and post-operative complications in relation to individual surgeons and mode of anaesthesia (local or spinal), and continence at short term follow up. Results Bladder or urethral perforation occurred in 26 cases (15%) and three operations were abandoned for these reasons. A failure to void after the first 24 hours was registered in 35 (20%); 21 (12%) had to undergo urethral dilatation while five patients (2.8%) had persistent urinary retention which required excision of the sling. These problems were significantly associated to the experience of surgeon. In seven cases (4%) haemorrhage required intravaginal tamponade. In three (1.7%) sling rejection occurred post-operatively. When followed up six to eight weeks post-operatively, 154 patients (88%) reported subjective cure, 21 (11%) significant improvement and two (1%) no improvement. The use of spinal anaesthesia increased the frequency of peroperative bladder perforation but affected neither the incidence of post-operative bladder obstruction nor the outcome at follow up. Conclusions This study identifies short term complications which relate partly to the experience of the individual surgeon. Nevertheless the 88% subjective cure rate was independent of these factors.

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“…Catheters were removed after two consecutive residual volumes of less than 100 mL were obtained. Insertion of TVT was performed as described 13 under local or regional anaesthetic. Regional anaesthetic was employed for patients having additional vaginal surgery procedures at the same time.…”

Section: Methodsmentioning

confidence: 99%

Morbidity of incontinence surgery in women over 70 years old: a retrospective cohort study

Pugsley¹,

Barbrook²,

Mayne³

et al. 2005

BJOG

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Objective To compare the success rate and complications after colposuspension and tension-free vaginal tape (TVT) insertion in women aged 70 years or more compared with younger women. Design A retrospective study of patients having surgery between November 2000 and October 2002.Setting A tertiary referral, academic urogynaecology unit in a University teaching hospital.Population Two hundred and twenty-six women having surgical treatment for urinary incontinence.Methods Data on cure/improvement and complications were extracted from the notes. Patients were grouped by age at surgery and the odds ratios (OR) and 95% confidence intervals (CI) for each outcome were calculated. Main outcome measures Subjective cure rate and the incidence of complications by age group.Results One hundred and three patients had colposuspension, 11 (10.7%) aged 70 or more. One hundred and twenty-three patients had TVT insertions, 23 (18.7%) aged 70 or more. The cure rate for each procedure was similar between age groups. After colposuspension, urinary tract infection (UTI; OR 11.33; 95% CI 2.61, 49.28) and long term self-catheterisation (percentage of difference 9.1; 95% CI 3.0, 15.2) were more common in women over 70. After TVT, repeat urodynamics (OR 3.91; 95% CI 1.11, 13.76), recurrent UTI (OR 4.22; 95% CI 1.03, 17.26) and tape division (OR 29.12; 95% CI 3.20, 264.86) were more common in older women. Conclusions Incontinence surgery carries a higher risk of complications in the elderly including UTI and voiding dysfunction. Extended antibiotic prophylaxis and intermittent self-catheterisation training should be offered to elderly women before surgery.

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A three‐year follow up of tension free vaginal tape for surgical treatment of female stress urinary incontinence

Cited by 536 publications

References 13 publications

Experience of tension-free vaginal tape for the treatment of stress incontinence in females with neuropathic bladders

Experience of tension-free vaginal tape for the treatment of stress incontinence in females with neuropathic bladders

Short term complications of the tension free vaginal tape operation for stress urinary incontinence in women

Morbidity of incontinence surgery in women over 70 years old: a retrospective cohort study

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