Tension-free vaginal tape (TVT) in women with low urethral closure pressure

Liapis, Angelos; Bakas, Panagiotis; Salamalekis, E.; Botsis, D.; Creatsas, G.

doi:10.1016/j.ejogrb.2004.02.009

Cited by 52 publications

(42 citation statements)

References 14 publications

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“…Numerous studies have shown satisfactory results of TVT with lower risk of complications that is comparable to the pubovaginal sling procedure and retropubic urethropexy, which have been the standard antiincontinence surgical procedures. Furthermore, high failure rates after performing retropubic urethropexy in patients with ISD has been noted in some studies [7,8], and a few reports have suggested that TVT might be effectively used in such cases [9][10][11]. Nevertheless, there has been no wellcontrolled study to confirm these reports.…”

Section: Introductionmentioning

confidence: 49%

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Treatment outcome of tension-free vaginal tape in stress urinary incontinence: comparison of intrinsic sphincter deficiency and nonintrinsic sphincter deficiency patients

et al. 2007

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The object of this study was to compare the treatment outcomes of tension-free vaginal tape (TVT) for intrinsic sphincter deficiency (ISD) and nonintrinsic sphincter deficiency (NISD) patients in stress urinary incontinence (SUI) and to evaluate whether TVT can be effectively used in both groups of patients. 111 women with SUI treated by TVT procedure from June 2003 to June 2005 with follow-ups for at least 1 year postoperatively were included in this study. The patients were divided into two groups: 31 patients with ISD and 80 patients with NISD. ISD was defined as the cases with low Valsalva leak-point pressure (VLPP) or Maximal urethral closure pressure (MUCP). Patients were followed up at 1, 3, 6, and 12 months postoperatively. There were no significant differences found in demographics between ISD and NISD groups: mean age, parity, body mass index, menopausal status, and hormone replacement therapy (p > 0.05). All urodynamic parameters except for VLPP and MUCP showed no significant differences. The cure rates of the two groups at 1 month follow-up (87.0 vs 100%; p = 0.0053) showed a significant difference, but no significant differences were found at 3, 6, and 12 months. There were no differences in postoperative complication rates (voiding difficulty, de novo urgency, urinary tract infection, retropubic hematoma, and vaginal mesh erosion) between the two groups irrelevant of follow-up months. TVT is effective for SUI in both ISD and NISD patients.

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Section: Introductionmentioning

confidence: 49%

“…Since the first report by Ulmsten et al, numerous reports on the TVT procedure for the treatment of SUI have shown successful outcomes (80-90%). Furthermore, a few reports have presented satisfactory outcomes (73-91.4%) in patients with ISD [9][10][11].…”

Section: Discussionmentioning

confidence: 99%

Treatment outcome of tension-free vaginal tape in stress urinary incontinence: comparison of intrinsic sphincter deficiency and nonintrinsic sphincter deficiency patients

et al. 2007

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“…The clinical relevance of this parameter has been reported by some authors, showing that the surgical treatment of USI has a higher failure rate in patients with a fixed urethra (usually presumed to be due to intrinsic sphincter deficiency) when compared to those with urethral hypermobility (i.e. patients with an upward movement of the urethral axis >30°during a Valsalva maneuver) [1][2][3][4]. These findings can therefore have important implications influencing therapeutic choice and the counselling of patients.…”

Section: Introductionmentioning

confidence: 86%

Inter-observer reliability of three different methods of measuring urethrovesical mobility

et al. 2008

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The aim of this study was to assess the inter-observer reliability of three different methods to evaluate urethral mobility in women: Q-tip test, ultrasonographic measurement and Sensor-Q test. From November 2006, consecutive women referred to our urogynecology units were submitted to one of the three procedures performed by two different urogynecologists, one blinded to the measurement obtained by the other. Sensor-Q test was performed using the specific equipment able to electronically assess urethral mobility. Data were analyzed using Pearson product moment correlation coefficient and Bland-Altman method comparison. Ninety patients were assessed. The Q-tip test, the Sensor-Q test and the ultrasonographic measurement were performed on 30 patients for each procedure. The correlation coefficient of the Q-tip test, the Sensor-Q test and the ultrasonographic measurement was 0.83, 0.92 and 0.43, respectively. The Sensor-Q and Q-tip test showed a higher inter-observer reliability for the evaluation of urethral mobility if compared to ultrasounds.

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“…La presenza di un deficit sfinterico intriseco è considerato un elemento prognostico sfavorevole nella chirurgia anti-incontinenza (48,49,50,51,52,53). La diagnosi di deficit sfinterico si fonda su due parametri urodinamici , non da tutti condivisi, di MUCP <20 cm H20 e VLPP <60 cm H20.…”

Section: Advanced Diagnostic Testing For Female Pelvic Floor Dysfunctunclassified

“…However, the differentiation of ISD from urethral hypermobility has been questioned, based on the lack of a validated, reliable and widely accepted marker for these conditions. Although lower preoperative MUCP has been associated with higher failure rates (48,49,50,52,53), there is increasing acknowledgement that procedures that were believed to be suitable for only ISD or urethral hypermobility are actually suitable for both types of SUI. TVT (traditionally used for urethral hypermobility) outcomes were found to be no different when stratified into ISD or hypermobility groups by MUCP or VLPP [36] and periurethral collagen injections (traditionally used for ISD) caused a 40-46% improvement in both ISD and urethral hypermobility on urodynamics [37].…”

Section: Deficit Sfintericomentioning

confidence: 99%

Advanced Diagnostic Testing for Female Pelvic Floor Dysfunctions

Vignoli¹

2010

UIJ

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SUMMARYThe word "pelvic floor dysfunction" has different meanings in different specialties, i.e. radiology, urology, gynaecology, coloproctology. Despite the fact that the concept of perineology is not exactly new, most clinicians have only slowly adapted their practice to this transversal view. The multidisciplinary approach (several specialists dealing with various pelvic floor problems) still prevails over the interdisciplinary one (one specialist explaining what is happening) with several problems in the choice of therapeutic strategies. Obviously, the interdisciplinary approach requires a wide knowledge of the principles and techniques of each specialty. This monographic issue reviews advanced diagnostic testing for female pelvic floor dysfunctions from the perspective of a single specialist, namely a urologist. SOMMARIOIl termine "disfunzione pelvica" riveste un diverso significato nelle diverse specialità. Nonostante, infatti, il concetto di approccio multidisciplinare alle problematiche del pavimento pelvico non sia propriamente nuovo, i clinici si sono dimostrati lenti nell'adattare la propria pratica ad una visione trasversale del problema. L'alternativa alla multidisciplinarietà è l'interdisciplinarietà, nella quale un singolo specialista prende in carico il paziente esaminandolo sotto tutti i punti di vista. È intuitivo che per un simile approccio non si possa prescindere da una conoscenza specifica del bagaglio culturale di ogni singola specialità. Questo numero monografico rappresenta un tentativo di approccio globale alle disfunzioni del pavimento pelvico da parte di un singolo specialista, urologo nella fattispecie.

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Tension-free vaginal tape (TVT) in women with low urethral closure pressure

Cited by 52 publications

References 14 publications

Treatment outcome of tension-free vaginal tape in stress urinary incontinence: comparison of intrinsic sphincter deficiency and nonintrinsic sphincter deficiency patients

Treatment outcome of tension-free vaginal tape in stress urinary incontinence: comparison of intrinsic sphincter deficiency and nonintrinsic sphincter deficiency patients

Inter-observer reliability of three different methods of measuring urethrovesical mobility

Advanced Diagnostic Testing for Female Pelvic Floor Dysfunctions

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