Long-term subjective results of tension-free vaginal tape operation for female urinary stress incontinence

Abstract

Urological Survey 795 Editorial CommentWe do not yet have a urethral stent that is ready for broad application. The authors describe their experience with Memotherm. This is a stent that contracts in cold water and expands after being placed in the urethra at body temperature. Removing it is fairly easy after irrigating the urethra with cold water. This is a big improvement over the Urolume stent which is very difficult to extract. Still the results reported herein show that there is still much room for improvement in the design of urethral stents, or that stents hold limited promise in urethral stricture management. Approximately half of the patients required secondary procedures for restenosis or "hyperplastic ingrowth" inside the stent. The true future of stents likely lies in drug-eluting stents or temporary stents acting as scaffolds for engineered tissue ingrowth. Introduction and Hypothesis: The aim of the study was to evaluate the subjective outcome between 1 and 5 years after tension-free vaginal tape (TVT) operation and the need for follow-up. Methods: A prospective questionnaire study was performed including questions about incontinence, urinary tract infection, emptying problems, the wish for a clinical control and the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Results: One hundred seventy-three patients were included. There were more patients with subjective recurrent stress incontinence over the years, but ICIQ-SF was unchanged. There was no rise in patients reporting urge incontinence over the years. Only 11.4% of the patients wished for a clinical control at some time. Conclusion: The TVT operation showed a slight degree of subjective deterioration between 1 and 5 years after the operation; however, the ICIQ-SF was unchanged. There seems to be no need for long-term follow-up at the operating department.

Medium-term and long-term outcomes following placement of midurethral slings for stress urinary incontinence: a systematic review and metaanalysis

“…Among the non-RCT studies, SUI was clinically diagnosed in eight (no urodynamic studies performed) [26,34,36,41,48,51,53,60] and a blinded assessment was performed in only three [40,50,51] (Figure in Electronic supplementary material). Outcome was assessed as a composite measure of cure (objective and subjective definition of cure met) [20,24,30,31,35,59], subjective [14,19,21,26,34,36,38,39,42,44,48], objective outcome [15,16,22,50] or both [17, 18, 23, 25, 27-29, 32, 33, 37, 40, 41, 43, 45-47, 49, 51-58, 60-62]. The follow-up was described in each study with a minimum of 36 months and a maximum of 17 years.…”