A 2 to 6 year postoperative evaluation of tension-free vaginal tape (tvt): a questionnaire based study
Abstract
Background: The purpose of this article is to show the long-term subjective cure rate of urinary incontinence in patients after the tension-free vaginal tape (TVT) procedure and eventual correlation of some factors with this cure rate.
Methods: From December 1999 to July 2004 we performed one hundred and fifty TVT procedures at our Department of Gynecology and Obstetrics. In April 2006, a 2 to 6 year postoperatively, 149 questionnaires were sent to our patients for self-estimation of the cure rate. The subjective evaluation of results of the operation was based on definition of the improvement of continence in percents, with 13 possibilities ranging from –20 % to 100 %. With tests of correlation we wish to establish eventual connection between the cure rate of urinary incontinence and the age of women at the time of operation and the number of postoperative years. Statistical significance of eventual influence of independent variables on cure rate was analyzed using nonparametric tests in Statistical Program Package for Social Sciences (SPSS).
Results: Of 119 answers, in 40 cases (33.6 %) patients confirmed that they are completely healthy, and 87 women (73.1 %) confirmed at least 70 % cure rate. 100 answers confirmed that 87.6 % patients had benefited by TVT procedure even 2 to 6 years postoperatively. Correlation between the long-term cure rate and the patient’s age at time of operation had Pearson’s correlation coefficient r = –0.335 and was statistically significant (p = 0.01). Statistically significantly different success was still in the groups with regard to the previous hysterectomy (p = 0.005) and the previous surgical procedure for urinary incontinence (p = 0.001). There was no statistically significant difference between the cure rate and the number of postoperative years (p = 0.236).
Conclusions: 150 TVT procedures were performed very safely as solo intervention or as connected with other repair of pelvic organ prolapse at our department and have excellent long-term results. The cure rate in our group was connected with the patient’s age at time of operation and with previous hysterectomy and/or surgical procedure for urinary incontinence respectively.
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References
Ulmsten U, Petros P. Intravaginal slingplasty (IVS): an ambulatory surgical procedure for treatment of female urinary incontinence. Scan J Urol Nephrol 1995; 29: 75–82.
Ulmsten U, Henriksson L, Johnson P, Varhos G. An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 1996; 7: 81–6.
Lukanovič A, Kralj B. TVT – advantages of microinvasiveness and cost-effectiveness. Int Urogynecol J 2002; 13 Suppl 1: S76.
Lukanovič A. Sodobni terapevtski pristopi pri zdravljenju urinske inkontinence. Zdrav Vestn 2003; 72 Suppl II: 171–5.
Kralj B. Epidemiology of female urinary incontinences. Classification of urinary incontinence, urinary incontinence in elderly woman. Eur J Obstet Gynecol Reprod Biol 1994; 55: 39–41.
Ulmsten U, Johnson P, Rezapour M. A 3 year follow up of tension free vaginal tape for surgical treatment of female stress urinary incontinence. Brit J Obstet Gynecol 1999; 106: 345–50.
Moran PA, Ward KL, Johnson D, Smirni WE, Hilton P, Bibby J. Tension free vaginal tape for primary genuine stress incontinence. Br J Urol 2000; 86: 39–42.
Nilsson CG, Kuuva N. The tension free vaginal tape procedure successful in the majority of women with indications for surgical treatment of urinary stress incontinence. Br J Obstet Gynecol 2001; 108: 414–9.
Groutz A, Gordon D, Wolman I, Jaffa AJ, David MP, Lessing JB. Tension-free vaginal tape for stress urinary incontinence: is there a learning curve? Neurourol Urodyn 2002; 21: 470–2.
But I, Faganelj M. Subjektivna ocena izboljšanja po operaciji z nožničnim nenapetostnim trakom (TVT) pri zdravljenju žensk z urinsko inkontinenco – raziskava na podlagi vprašalnika. Zdrav Vestn 2003; 72 Suppl II: 163–6.
Barry CL, Dietz HP, Rane A, Wilson PD. Is the cough test necessary? A case control series of two techniques of TVT adjustment. Neurourol Urodyn 2004; 23: 492–3.
Ward KL, Hilton P. A prospective multicenter randomized trial of tension-free vaginal tape and colposuspension for primary urodynamic stress incontinence: two-year follow-up. Am J Obstet Gynecol 2004; 190: 324–31.
Reich A, Kohorst F, Muche R, Kreienberg R, Flock F. Ergebnisse und Einflussfaktoren bei Einlage eines spannungsfreien Vaginalbandes nach dem TVT®-Verfahren. Geburtsh Frauenheilk 2006; 66: 365–72.
Schraffordt Koops SE, Bisseling TM, van Brummen HJ, Heintz APM, Vervest HAM. What determines a successful tension-free
vaginal tape? A prospective multicenter cohort study: Result from The Netherlands TVT database. Am J Obstet Gynecol 2006; 194: 65–74.
Lužnik M. Uporabnost propilenske mrežice pri motnjah funkcije medeničnega dna. In: Kralj B, Denona V, eds. Zbornik 2. kongres ginekologov in porodničarjev Slovenije z mednarodno udeležbo; 2000 Nov 19-22; Portorož. Ljubljana: Združenje ginekologov in porodničarjev Slovenije; 2000. p. 133.
Lužnik M. Tension-free vaginal tape (TVT) in combination with reconstructive pelvic floor operation. In: Abstract book of the World congress on gynecological endoscopy, 1st Croatian congress on gynecological endoscopy; 2002 May 15-18; Dubrovnik. Dubrovnik: Croatian Society of Gynecological Endoscopy; 2002. p. 30.
Lužnik M. A four-year experience in use of mesh patch for correction of female pelvic organ prolapse (POP) and pelvic floor dysfunction (PFD): A vaginal approach. In: Lukanovič A, Tamussino K, eds. Urogynecology today. Joint Meeting of Slovene Urogynecological Society and Austrian Society for Urogynecology and Pelvic Reconstructive Surgery, Portorož, September 24-25, 2004; 181–2.
Lužnik M. Mrežna krpa za korekcijo velike rektokele: prve izkušnje. Mesh patch for correction of large rectocele: first experience. Zdrav Vestn 2002; 71: 23–6.
Jomaa M. Combined tension-free vaginal tape and prolapse repair under local anaesthesia in patients with symptoms of both urinary incontinence and prolapse. Gynecol Obstet Invest 2001; 51: 184–6.
Buchsbaum GM, Albushies DT, Schoenecker E, Duecy EE, Glantz JC. Local anesthesia with sedation for vaginal reconstructive surgery. Int Urogynecol J 2006; 17; 211–4.
Lužnik M. Pooperativni zastoj urina in zgodnja repozicija nenapetostnega traku. Zdrav Vestn 2003; 72 Suppl II: 177–8.
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