Eleven years prospective follow-up of the tension-free vaginal tape procedure for treatment of stress urinary incontinence

Abstract

The aim of this study was to evaluate the long-term effectiveness and safety of the tension-free vaginal tape (TVT) procedure. In a Nordic three-center prospective observational cohort study, 90 women with primary stress incontinence had a TVT operation performed in local anesthesia. Assessment included a 24-h pad test, a stress test, physical examination, and a visual analog scale for assessing the degree of bother. Patient's global impression of cure was obtained, and condition specific quality of life questionnaires were used. Seventy-seven percent of the initial cohort of 90 women and 89% of those alive and capable of cooperating were assessed 11.5 years after the TVT operation. Ninety percent of the women had both a negative stress test and a negative pad test being objectively cured. Subjective cure by patients global impression was found in 77%, 20% being improved and only 3% regarded the operation as a failure. No late-onset adverse effects of the operation were found, and no case of tape erosion was seen. The TVT procedure is safe and effective for more than 10 years.

Perioperative Complications in Vaginal Mesh Procedures Using Trocar in Pelvic Organ Prolapse Repair

“…Recently, synthetic materials are increasingly used in urogynecologic surgery. Suburethral slings like tension-free vaginal tapes have become a popular treatment of choice for stress urinary incontinence, owing to high success rates and few side effects [1]. Mesh patches have also been introduced in prolapse surgery as an effective method in dealing with the high recurrence rates of traditional surgeries.…”

Single-Incision Slings (SIS) - a New Option for the Surgical Treatment of Female Stress Urinary Incontinence

“…The retro-pubic approach with introduction of the tape via a small colpotomy in the midpart of the urethra and in supra-symphysary design (bottom-top = TVT ® plastic, Gynecare) has been used the longest and has the most study results. Current data from 2008, with a follow-up time of 11.5 years, confirm the high efficiency of the method, with an objective continence rate of 90 %, a subjective continence rate of 77% and an improvement of 20 % (LoE II) [1]. According to a Cochrane analysis, the retro-pubic route with needle guided from the abdomen to the vagina (top-bottom, e.g.…”

Choosing the right sling for your patient

“…Depending on the definition used to define cure, the objective and subjective cure rates appear to be statistically similar with all sling modalities for the uncomplicated patient with stress incontinence. [5][6][7][8][9][10] There does, however, appear to be a significant difference in complications between the approaches. The retropubic approach demonstrates an increased risk of intraoperative bladder perforations, de novo urgency and storage lower urinary tract symptoms (LUTS), while transobturator routes show an increased risk of vaginal erosion and groin pain.…”