J Korean Continence Soc.  2006 Jun;10(1):9-16.

Predictive Factors Affecting Long-term Cure and Patient Satisfaction of the Tension-free Vaginal Tape Procedure for the Treatment of Female Stress Urinary Incontinence

• Doo CK
• Kim JB
• Kim WS
• Park JS
• Chung BJ
• Kim JY
• Jung HC
• Lee KS
• Choo MS

Abstract

PURPOSE
We evaluated predictive risk factors affecting the long-term efficacy of the tension-free vaginal tape(TVT) procedure for the treatment of female stress urinary incontinence(SUI).
MATERIALS AND METHODS
We included 138(mean age 52.4+/-9.3) women who underwent the TVT procedure and followed up for at least 5 years. We analyzed parameters including patient characteristics, history, physical examination, 1-hour pad test, and urodynamic studies using univariate and multivariate analyses with respect to the cure rates. The patients were regarded as cured in the absence of any episodes of involuntary urine leakage during stressful activities and stress cough test.
RESULTS
The overall 5-year cure rate was 76.8%, with an 86.9% patient satisfaction rate. On univariate and multivariate analyses, there were no significant parameters affecting the cure rate. The urgency negatively impacted patients' satisfaction(p=0.017, OR=4.114). According to the subgroup analyses, cure rates were lower in patients with high body mass index(BMI=25 kg/m(2), 68.3% vs 83.3%, p=0.044), lower Valsalva leak point pressure(VLPP<60 cmH2O, 51.6% vs 82.8%, p=0.003), and high-grade incontinence(40.0% vs. 69.7%, 86.6%, p=0.012).
CONCLUSION
the TVT procedure is an effective and safe surgery for SUI without any independent predictive factors affecting long-term cure execept urgency affecting satisfaction. However, higher BMI, low VLPP and high- grade incontinence may impair the efficacy of the TVT procedure.

Keyword

Stress urinary incontinence; Tension-free vaginal tape; Predictive factors

MeSH Terms

Cough
Female*
Humans
Multivariate Analysis
Patient Satisfaction*
Physical Examination
Risk Factors
Suburethral Slings*
Urinary Incontinence*
Urodynamics