Predictive Factors for Persistent Urgency or Urge Incontinence after Tension-Free Vaginal Tape Procedure in Mixed Urinary Incontinence

Ku, Ja Hyeon; Shin, Jae Wook; Son, Hwancheol; Oh, Seung June; Kim, Soo Woong; Paick, Jae Seung

Abstract

PURPOSE: The factors for predicting persistent urge symptom and urge incontinence following a tension-free vaginal tape (TVT) procedure were investigated in patients with mixed urinary incontinence.
MATERIALS AND METHODS
Two hundred and seventy-four women, with a mean age of 55 years, ranging from 28 to 80, with female urinary incontinence (stress urinary incontinence; 201, mixed urinary incontinence; 73) were the subjects of this study. After a TVT procedure, the patients were followed up at 1, 6 and 12 months and every 1 year thereafter. Cure of incontinence after the procedure was defined as the absence of a subjective complaint of leakage and the absence of objective leakage on stress testing, with all other cases considered as failures.
RESULTS
There was no significant difference in the cure rates for stress urinary incontinence in patients with stress and mixed urinary incontinence. However, of 73 patients with mixed urinary incontinence, 20 (27.4%) ans 12 (16.4%) had persistent urgency and continued urge incontinence, respectively. In a multivariate analysis, a low maximal urethral closure pressure (MUCP) was found to be associated with an increased likelihood of persistent urgency (odds ratio, 0.94; 95% confidence interval, 0.38-0.99; p=0.029) and the persistent urge incontinence (odds ratio, 0.94; 95% confidence interval, 0.88-0.99; p=0.030) after a TVT procedure in patients with mixed urinary incontinence.
CONCLUSIONS
Our findings suggest that a low MUCP may be associated with the persistent urgency and urge incontinence after a TVT procedure in patients with mixed urinary incontinence.