A Long-Term Study of the Effects of the Tension-Free Vaginal Tape Procedure for Female Stress Urinary Incontinence on Voiding, Storage, and Patient Satisfaction: A Post-Hoc Analysis

Abstract

PurposeWe assessed the long-term effects of the tension-free vaginal tape (TVT) procedure for stress urinary incontinence (SUI) on voiding, storage, and patient satisfaction.Materials and MethodsThis retrospective study examined the records of 134 patients who had undergone the TVT procedure for SUI and were followed up for more than 5 years. Voiding function was evaluated by measuring maximum urinary flow rate (MFR), post-void residual urine volume (PVR), and storage function by using a voiding diary. Patients were asked to describe their satisfaction with the operation.ResultsMFR was lower at 1 month compared with the preoperative level, but had recovered to preoperative levels by 5 years postoperatively. However, some patients with >50%, 25-50%, and <25% decreases in the MFR at 1 month postoperatively showed a decrease in the MFR of >50% at 5 years. PVR increased over the 5 postoperative years. Of the patients with urgency and urgency incontinence, 43.8% and 48.1% showed improvement, respectively, whereas new patients developed postoperatively. Thus, the total number of patients with urgency or urgency incontinence remained similar over the 5 years. In those with a changed voiding pattern, patient satisfaction was negatively affected by de novo urgency and urgency incontinence and decreased MFR.ConclusionsAny obstructive effect of the TVT procedure diminished over time in most patients, although a decrease in the MFR was sustained in some patients. With regard to overactive bladder symptoms, some patients were cured and some patients complained of de novo symptoms. The most major factor affecting patient satisfaction was de novo urgency.

Association between the Urinary Bladder Volume and the Incidence of “De Novo” Overactive Bladder in Patients with Stress Urinary Incontinence Subjected to Sling Surgeries or Burch Procedure

“…Among the parameters analyzed by these authors were the bladder volumes determined one month, one year, and five years after the procedure. The authors did not document significant changes in the bladder volume of patients subjected to TVT surgery [31]. Our findings seem to be consistent with this observation.…”

“…Instead, they only showed that the bladder volume of patients subjected to Burch procedure decreased significantly, contrary to persons who were operated on according to TVT protocol [30]. The treatment outcomes in patients with stress urinary incontinence were also studied by Han et al [31]. Among the parameters analyzed by these authors were the bladder volumes determined one month, one year, and five years after the procedure.…”

Long‐term patient satisfaction after retropubic and transobturator mid‐urethral slings for female stress urinary incontinence

“…Voiding dysfunction had a significant negative impact on subjective patient satisfaction; the weaker the maximum flow rate, the less was patient satisfaction . Postoperative voiding dysfunction improved with time in most patients with mild voiding symptoms, but this was less likely to happen when voiding dysfunction was severe . None of the patients who underwent the retropubic approach needed ancillary continent procedures, but 2.3% of them needed sling release secondary to severe voiding dysfunction.…”