Determinants of Patient Dissatisfaction After a Tension-Free Vaginal Tape Procedure for Urinary Incontinence

Deval, Bruno; Jeffry, Louis; Najjar, Fadheela Al; Soriano, David; Daraı̈, Émile

doi:10.1016/s0022-5347(05)65092-6

Cited by 78 publications

(35 citation statements)

References 13 publications

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“…It was 20.2% in the current study and this is comparable with 21.3% reported by Deval et al [2]. Although Botros et al reported that the rate of de novo subjective urge urinary incontinence for TVT was significantly higher than that of Monarc and Sparc, [5] these differences were not found in the current study.…”

Section: Discussionsupporting

confidence: 83%

“…This issue has been rarely ever reported other than by Deval et al, Falconer et al, and Botros et al. They briefly hypothesized that the changes in paraurethral collagen metabolism or sclerosis around the sling, or the effect position of the sling may elicit the new onset of urge symptoms [2,3,5].…”

Section: Introductionmentioning

confidence: 95%

“…The reported incidence of de novo urge symptoms (DNUS) after mid-urethral sling procedure (MUSP) is various (ranged from 0 to 21.3%) [1,2,3]. Urgency is a sensation, which by its definition, is episodic, maximal, and unpredictable, thus, it is bothersome and has detrimental impact on the quality of life [4].…”

Section: Introductionmentioning

confidence: 99%

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A microbiological and immunohistochemical analysis of periurethral and vaginal tissue in women with de novo urge symptoms after mid-urethral sling procedures—a prospective case-controlled study

Wang

Lin

et al. 2008

Int Urogynecol J

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The aims were to determine whether bacteria-infection-elicited immune response after mid-urethral sling (MUS) may cause de novo urge symptoms (DNUS) and to evaluate the efficacy of suburethral sling excision for relieving the urgency. In a period of 40 months, 360 consecutive subjects with urodynamic stress incontinence had undergone one of three different MUS. Sixty-eight women with DNUS were included after exclusion. The suburethral sling of 24 of the 68 women needed to be excised because of refractory urgency. The excised vagina, or periurethral tissue, included sling of the study and control groups were sent for microbiological and immunohistochemical analyses. Statistically significant differences in the cell density percentage of CD68, CD25, CD4+CD25 and positive rate of Gram (+) bacteria were noted between two groups (p=0.024, p=0.053 and 0.016, respectively, p<0.001). The success rate of sling excision was 80.2%. In conclusion, bacteria-infection-related immune hyperreactivity might explain the pathologic basis of DNUS after MUS.

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 95%

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A microbiological and immunohistochemical analysis of periurethral and vaginal tissue in women with de novo urge symptoms after mid-urethral sling procedures—a prospective case-controlled study

Wang

Lin

et al. 2008

Int Urogynecol J

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“…Moreover, in this study lower subjective cure rates were obtained in women with mixed incontinence [11]. The same study also revealed that subjective cure rate was not affected by any other preoperative features of patient characteristics, including patient age.…”

Section: Discussionsupporting

confidence: 73%

“…Urinary retention was found to be between 2.3-13% in various series [7,10,11,17,18,19,20]. Spontaneous voiding with insignificant residuals was achieved in most of the patients within 2 weeks in these series.…”

Section: Discussionmentioning

confidence: 69%

Are there any factors predicting the cure and complication rates of tension-free vaginal tape?

Çeti̇nel

Demi̇rkesen

Önal

et al. 2004

International Urogynecology Journal and Pelvic Floor Dysfunctio

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Predictive factors that could possibly affect the cure and complication rates of tension-free vaginal tape (TVT) in the treatment of stress urinary incontinence (SUI) were investigated. Seventy-five consecutive patients with urodynamically proven SUI and who had undergone a TVT operation were evaluated according to a follow-up protocol. Median age was 51.2 (33-69). Thirteen (17%) of the patients had had previous anti-incontinence surgery. Sixteen (21%) patients had complained of pure stress and 59 (79%) of mixed incontinence. Valsalva leak point pressure (VLPP) values had been found to be below 60 cmH(2)O in 36 (48%) and over 60 cmH(2)O in 39 (52%) patients, while detrusor overactivity (DO) had been detected in six (8%) patients during urodynamic evaluation. Local, general, and epidural anesthesia had been performed in 43 (57%), 29 (39%), and three (4%) patients, respectively. Univariate analyses were done using Fisher's exact and Chi-square tests. Multivariate analyses were done using logistic regression test to determine predictive factors affecting cure and complication rates. Mean surgical and hospitalization times were 34.7 min (20-70) and 1.2 days (1-5), respectively. Mean follow-up was 21.6 months (6-38). Cure and improvement rates were 89 and 8%, respectively. Thirty-one complications were observed in 27 (36%) patients. Intraoperative bladder perforation and bleeding occurred in three (4%) and two (3%) patients, respectively. Sixty-six (88%) patients voided spontaneously after TVT while nine (12%) performed clean intermittent catheterization (CIC) for a period of time. Seven of nine patients regained the spontaneous voiding ability within 1 month. The tape was cut in two of these retentive patients and one with severe storage lower urinary tract symptoms (LUTS) either unilaterally or bilaterally. On univariate (Fisher's exact test, p =0.018), and multivariate (Logistic regression, p =0.013) analyses, patient age was the only statistically significant parameter affecting the cure rate, which was significantly lower particularly over 55 years of age. No significant factor predicting the complications was detected. TVT is an effective and safe surgical procedure in the treatment of SUI. In this study age was the only significant predictive factor affecting the cure rate while no significant factor predicting the complications was detected. Cure rate was significantly lower in patients over 55 years of age.

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Comparison of tension‐free vaginal taping versus modified burch colposuspension on urethral obstruction: A randomized controlled trial

Wang

Chen

2003

Neurourology and Urodynamics

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Determinants of Patient Dissatisfaction After a Tension-Free Vaginal Tape Procedure for Urinary Incontinence

Abstract: These results confirm that the tension-free vaginal tape procedure is associated with a high objective but lower subjective cure rate. The procedure performed using local anesthesia was associated with a lower incidence of difficult voiding and new onset urge symptoms.

Cited by 78 publications

References 13 publications

A microbiological and immunohistochemical analysis of periurethral and vaginal tissue in women with de novo urge symptoms after mid-urethral sling procedures—a prospective case-controlled study

A microbiological and immunohistochemical analysis of periurethral and vaginal tissue in women with de novo urge symptoms after mid-urethral sling procedures—a prospective case-controlled study

Are there any factors predicting the cure and complication rates of tension-free vaginal tape?

Comparison of tension‐free vaginal taping versus modified burch colposuspension on urethral obstruction: A randomized controlled trial

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