Effect of Tension-Free Vaginal Tape Procedure in Women with Recurrent Stress Urinary Incontinence

Kim, Dae Hee; Lee, Jeong Gu

Abstract

PURPOSE: To evaluate the efficacy of the tension-free vaginal tape (TVT) procedure in patients with recurrent stress urinary incontinence. Therefore, the effectiveness of the procedure in patients whom previous traditional surgical procedures had failed was retrospectively reviewed.
MATERIALS AND METHODS
A total of 48 women, in whom a previous traditional surgical procedure had failed, received the TVT procedure (Group I). A further 124 women received the TVT procedure as the primary anti-incontinence surgical procedure (Group II) over the same time period, who were followed up for at least 1 year after the TVT procedure, were also included in the study. The preoperative evaluations included a symptom questionnaire, physical examination and urodynamic evaluation. Uroflowmetry, postvoiding residual urine and the symptom questionnaire were evaluated postoperatively, and the pre- and postoperative results compared between the two groups. The surgical results were classified into 3 categories; cured, improved and failed.
RESULTS
According to the protocol, 40 (83.3%) and 106 (85.5%) patients in Groups I and II were cured. There were no significant differences in the cure rates between the two groups. Thirty four and 58 intrinsic sphincter deficiency patients were noted in Groups I and II, respectively; of these, 76.5 and 79.3% of the patients in groups I and II were cured of their incontinence. There were no significant differences in the incidences of intra- or postoperative complications, postoperative voiding problems and patient satisfactions between the two groups.
CONCLUSIONS
There were no differences in the results of the TVT procedure in women with recurrent stress urinary incontinence or who had received the procedure as the primary anti-incontinence surgical treatment. These results imply the TVT procedure can be performed as the primary choice in patients having failed previous anti-incontinence surgery.