Korean J Urol.
2001 Jun;42(6):589-593.
Early Clinical Outcome and Complications of Tension Free Vaginal Tape Procedure in Stress Incontinent Women
- Affiliations
-
- 1Department of Urology, Sungkyunkwan University School of Medicine, Seoul,
Korea.
Abstract
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PURPOSE: The aim of the study was to evaluate the clinical outcome and complications
of tension free vaginal tape (TVT) procedure for the surgical treatment of female stress
urinary incontinence.
MATERIALS AND METHODS
Between April 1999 and May 2000, 41 women with stress
urinary incontinence underwent TVT procedure. Preoperative evaluation included
questionnaires study, physical examination, one hour pad test and urodynamic study.
Postoperative clinical outcome, patient's satisfaction and complications were checked
after 3-months.
RESULTS
The mean age of patients was 51.6 years (range 40-76) and mean hospital
stay 2.1 days (range 1-10). The mean follow-up period was 9.9 months (range 3-15).
Thirty six patients (87.8%) were cured, 2 patients (4.9%) were improved. Two of 3
patients with failed operation who developed postoperative urge incontinence had grade
III cystocele. Five bladder perforations and 1 obturator nerve injury occurred. The
abdominal leak point pressure (LPP) increased from 50.6cmH20 to 110.8cmH2O,
detrusor pressure of maximal flow rate (Pdet.Qmax) increased from 15.8cmH2O to
28.6cmH2O and maximal flow rate (Qmax) decreased from 32.8ml/s to 22.5ml/s after
operation.
CONCLUSIONS
The TVT procedure is an effective and feasible surgical treatment for
female stress urinary incontinence. However, in patients with grade III cystocele,
postoperative urge incontinence may develop after the procedure. Since TVT procedure
involves securing the mid-urethra, urinary obstruction may also occur, necessitating
the need for continued follow-up as well as a careful comparison with other sling
procedure.