TVT-O for the Treatment of Pure Urodynamic Stress Incontinence: Efficacy, Adverse Effects, and Prognostic Factors at 5-Year Follow-up

Tension-free vaginal tape-obturator and tension-free vaginal tape-Secur for the treatment of stress urinary incontinence: a 5-year follow-up randomized study

“…Indeed, no new cases of vaginal exposure or persistent or chronic groin/thigh pain was observed in either groups. This results is consistent with other medium-term studies on TVT-O, showing virtually no cases of chronic pain [9,14,[23][24][25]. Considering that TVT-Secur was developed primarily to reduce persistent pain, it is clear that, in the long-term, this seems not to be an advantage.…”

Long-term efficacy of the trans-obturator and retropubic mid-urethral slings for stress urinary incontinence: update from a randomized clinical trial

“…3), our results confirm the findings of previous studies on the long-term results after MUSs. Our results also add a further consideration, which is the stability of the incontinence results (in particular for TVT), over time [4,11,18]. Within 25 months of the initial surgery, the failure rate was relatively high for both the slings, following which it stabilized.…”

“…It is almost impossible to address this large discrepancy, as it could be related to different definitions and questionnaires adopted to collect OAB symptoms, to the different demographic characteristics of women included, or to the different concomitant surgical procedures associated with TVT. In their long-term results after TVT-O, Serati et al [18] reported 24.3 % of patients with de novo OAB symptoms after 5-year follow-up. Our long-term findings (presence of storage symptoms in 20 % of the TOT group and 36.8 % of the TVT group) and the Kaplan-Meier curve, describing the onset of post-operative storage symptoms, confirmed the relevance of this problem and how it tends to worsen over time.…”

Surgical outcome of a repeat midurethral sling procedure after failure of a first procedure

“…Although MUS procedures have a success rate greater 85 % [5][6][7][8], about 20 % of patients will experience persistent or recurrent SUI [1,9,10], indicating the need for an appropriate secondary procedure. The reasons for failure of the primary MUS procedure are unclear but may be related to misplacement of the suburethral tape, inadequate tension on the tape, local fibrotic reactions, or healing abnormalities.…”

“…The retropubic tension-free vaginal tape (TVT) procedure has an objective cure rate at 11 years of 84 -90 % [5,6], and the tensionfree vaginal transobturator tape inside-out (TVT-O) and outside-in (TOT) procedures have comparable efficacy at 5 years [7,8]. Despite the high success rates of MUS qqs, their widespread use has led to a greater absolute number of failures, as 5 -20 % of treated patients show persistent or recurrent SUI following a failed MUS qq [1,9,10].…”