Tension-Free Vaginal Tape (TVT) in Women with Mixed Urinary Incontinence – A Long-Term Follow-up

Abstract

In a prospective long-term study we evaluated the effect of TVT surgery in 80 women suffering from mixed urinary incontinence. Their mean age was 59 +/- 11 years with a mean parity of 2 (range 0-6). Mean follow-up was 4 years (range 3-5). The preoperative evaluation included a 24-hour pad test, quality of life evaluation, gynecologic examination and urodynamic investigations, including simultaneous urethrocystometry. From the patient history 96 patients were initially tentative candidates for TVT operation. Sixteen of these had only minor symptoms and signs of stress incontinence but significant symptoms and signs of detrusor instability, and were not considered suitable for TVT surgery. In the remaining 80 women the urodynamic investigation with filling urethrocystometry demonstrated stress incontinence and urge incontinence concomitant with urethral relaxation and/or 'premature micturition' reflex. At the postoperative long-term follow-up 85% of the patients were completely cured. Another 4% were significantly improved. In 11% of the patients the operation failed. Few intra- or postoperative complications occurred. Based on these results, we conclude that TVT surgery can be used for treatment of female mixed urinary incontinence. A proper urodynamic assessment is recommended before surgery is performed.

The tension free vaginal tape operation for women with mixed incontinence: Do preoperative variables predict the outcome?

“…Neurourology and Urodynamics DOI 10.1002/nau The study of Rezapour and Ulmsten [2001] had a better cure rate for mixed incontinent women after TVT than ours and the above mentioned articles. The reason could be that they did not include patients with predominant urge incontinence symptoms.…”

“…Cure was obtained in 72% of our mixed incontinent women after TVT, while Rezapour and Ulmsten [2001] found 85% of their mixed incontinent women to be cured after TVT. After 1 and 2 years, Debodinance et al [2002] found 91% and 83% of stress incontinent and 85% and 60% of mixed incontinent women to be cured, respectively.…”

“…Involuntary leakage associated with urgency was thought to cause failure in surgery for stress incontinence [Bates et al, 1973], and surgery was therefore only considered appropriate when a cystometrogram showed no detrusor overactivity [Stanton, 1991]. However, recent studies show a reduction in urge incontinence symptoms and detrusor overactivity after successful surgery for stress incontinence [Cucchi, 1998;Rezapour and Ulmsten, 2001]. Cystometry has low diagnostic sensitivity [Kulseng-Hanssen and Klevmark, 1988;Robertson et al, 1991;vanWaalwijk van Doorn et al, 1992;Gri⁄ths, 1998;Radley et al, 2001].…”

Transobturator mid urethral sling surgery for stress urinary incontinence: our experience

“…13 In our study, we had one case (2.08%) of vaginal erosion of the mesh with Gynecare TVT-O tape who presented on the 2 nd postoperative month with severe dyspareunia. The exposed part of the mesh was excised and the patient was relieved of her symptoms with no recurrence.…”

Tercera Generación en Cirugía Mínimamente Invasiva Para La Corrección De La Incontinencia De Orina De Esfuerzo: TVT-Secur

“…Una de las más exitosas han sido las que ubican una cinta en posición media suburetral, ya que ofrecen todas las ventajas de una cirugía mínimamente invasiva con un alto porcentaje de corrección. La primera de ellas fue el TVT (Trans-Vaginal-Tape) descrito en 1996 por Ulmsten (1,2), cirugía que requiere de cistoscopia para comprobar la indemnidad vesical (3). Delorme en 2001describe la técnica de TOT (Trans-Obturator-Tape) (4,5), que no requiere de citoscopía, posee menos riesgo de perforación de vejiga y las agujas no pasan por el espacio retropúbico (6).…”