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

Jung, Yeo Hwa; Jeon, Myung Jae; Chung, Da Jung; Park, Joo Hyun; Kim, Sei Kwang; Kim, Jae Wook; Bai, Sang Wook

Abstract

OBJECTIVE
The object of this study is to compare treatment outcomes of tension free vaginal tape (TVT) for intrinsic sphincter deficiency (ISD) and non-intrinsic sphincter deficiency (NISD) patients in stress urinary incontinence (SUI), and to evaluate whether TVT can be effectively used in both groups of SUI patients.
METHODS
111 women with SUI treated by TVT at the Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, the Yonsei Medical Center from Jun. 2003 to Jun. 2005 were included in this study. The patients were divided into two groups; 31 patients with ISD, and 80 patients with NISD. SUI was diagnosed according to the result of urodynamic tests. Urodynamic studies (UDS) include uroflowmetry, multi-channel cystometry and urethral pressure profilometry. The Patients were followed up at 1, 3, 6, and 12 months postoperatively, and those with any follow-up loss were excluded from this study.
RESULTS
There were no significant differences found in demographics between ISD and NISD groups; mean age, parity, BMI, menopausal status and HRT (P>0.05). Maximum urethral closure pressure (MUCP)(46.8124.29 vs.75.7+/-32.61 cmH2O; P<.0001) and Vasalva leak-point pressure (VLPP)(53.48+/-10.12 vs 107.23+/-42.95 cmH2O; P<0.0001) showed significant difference between the two groups. However, other parameters of UDS except MUCP and VLPP showed no statistical difference. The cure rates of the two groups at 1 month follow up (87.0% vs 100%; p=0.0053) showed significant difference. No significant differences were found at 3, 6 and 12 months. There were no differences in postoperative complication rate (voiding difficulty, de novo urgency, urinary tract infection) between two groups irrespective of follow-up months.
CONCLUSION
Tension-free vaginal tape is effective for stress urinary incontinence in both ISD and NISD patients.