Outcomes of Tension-free Vaginal Tape According to Postoperative Period in the Treatment of Female Urinary Incontinence

Bang, Seong Ik; Lee, Jeong Zoo

Abstract

PURPOSE: To study the outcomes and complications of tension-free vaginal tape(TVT) operations, according to postoperative period, and compare our results with those in the literature.
MATERIALS AND METHODS
340 patients were followed up for at least 3 months, between March 1999 and September 2001. During the postoperative period, the objective and subjective success rate, along with the postoperative complications, were evaluated. The mean age was 50.6+/-10.1 years. Among the 340 patients, 279(81.8%) and 61(19.4%) were diagnosed with stress and mixed incontinences, respectively. The patients were classified according to their symptom grades; grade I(n=66, 19.4%), grade II (n=240, 70.6%) and grade III(n=34, 10.0%).
RESULTS
113, 117, 44 and 66 of the 340 patients were observed postoperatively for 1, 1-2, 2-3 and for over 3 years, respectively. Of these, 137 completed questionnaires for evaluation of the subjective outcome. The objective success rates were high, irrespective of the extent of the postoperative period. The 1, 1-2, 2-3 and over 3 years postoperative period objective success rates were 93.8, 87.5, 89.5 and 93.3%, respectively. The subjective success rates were also high, irrespective of the extent of the postoperative period; 87.5, 75.0, 84.3 and 90.0% 1, 1-2, 2-3 and beyond 3 years, respectively. Postoperative complications occurred in 15 cases, including 12 bladder perforation due to the TVT device, 2 cases of bladder injury due to guide wire and one of vessel injury. 13 cases developed de novo urgency, although, they were cured with anticholinergic medication. Other serious complications, such as wound infection, hemorrhage requiring transfusion and nerve injury, were absent.
CONCLUSIONS
Both the short and long term results were excellent, regardless of the extent of the postoperative follow-up period. TVT should play a significant role in treating female urinary incontinence, due to its availability and stability.