Treatment of Voiding Dysfunction Following Tension Free Vaginal Tape Procedure for the Patient of Stress Urinary Incontinence

Lee, Seong Ho; Jung, Hee Chang

Abstract

PURPOSE: The aims of this study were to analyze the types of voiding dysfunction following a tension free vaginal tape (TVT) procedure, and to report our experience of diagnosing and treating post-TVT voiding dysfunction.
MATERIALS AND METHODS
A TVT procedure was performed on 201 patients, of which, 51 (25.4%) developed a voiding dysfunction. The TVT was incised or released to increase the uroflow and decrease the residual urine volume for those whose symptoms were not controlled by anticholinergics (tolterodine, propiverine) and/or alpha-blockers (alfuzocin, terazocin) or clean intermittent catheterization (CIC). The success rate and degree of satisfaction were investigated for the correction of stress incontinence.
RESULTS
In 36 patients, the voiding symptoms improved after medication administration, with a mean interval of 16.5 days. Another 15 patients required a TVT incision or release at means of 27 and 8 days, respectively. After the incision or release of the TVT sling, the mean maximal flow rate (MFR) increased from 9.3+/-4.3 to 21.7+/-6.7ml/sec, and mean residual urine volume (RU) decreased from 277.9+/-156.2 to 24.6+/-16.0ml. The success rate and satisfaction of the TVT procedure were 98.0 and 90.4%, respectively. Lastly, 88.3% of the subjects reported they would recommend the TVT procedure to people they know with symptoms of stress urinary incontinence.
CONCLUSIONS
This study suggests that voiding dysfunction, with normal uroflow and RU, may be effectively controlled with conservative treatment. However, when the voiding dysfunction is accompanied by a decreased MFR and an increased RU, an additional procedure, such as the TVT incision or release, is recommended.