Evaluation of Tension&amp;ndash;Free Vaginal Tape Procedure

Lebrét, Thierry; Lugagne, Pierre-Marie; Hervé, Jean-Marie; Barré, Philippe; Orsoni, Jean-Luc; Yonneau, Laurent; Saporta, François; Botto, Henry

doi:10.1159/000049833

Cited by 78 publications

(35 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, there were studies reporting that the risk of bladder perforation increased with previous unsuccessful antiincontinence surgeries, and surgical inexperience could result in both high bladder perforation and urinary retention rates [17,18]. Kuuva et al reported that the risk of complication rate was high in centers where TVT was occasionally performed [19].…”

Section: Discussionmentioning

confidence: 99%

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

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

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

View full text Add to dashboard Cite

show abstract

“…In Ulmsten's initial publication, there were no cases of prolonged urinary retention [1].No subsequent authors have been able to duplicate these results, with retention rates reported at 3%-11% [2,3,4]. There are recent reports of patients who experienced increased voiding difficulty with time.…”

Section: Discussionmentioning

confidence: 99%

“…Since its initial description by Ulmsten et al in 1996, what is now known as the 'transvaginal tape or tension-free tape' has gained immense popularity because of its simplicity, shortened hospital stay and low rate of complications [1,2,3]. Recently, however, complications such as urinary retention and urethral erosion have been reported [4,5,6]. Authors have ascribed these complications to overzealous tightening [4], but there have been no articles specifically assessing this issue.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The position of the urethrovesical junction after incontinence surgery: early postoperative changes

McLennan

Melick

Cannon

2004

International Urogynecology Journal and Pelvic Floor Dysfunctio

View full text Add to dashboard Cite

This study prospectively evaluated the position of the urethrovesical junction using the Q-tip angle to assess early postoperative changes for different anti-incontinence surgeries. All procedures resulted in a statistically significant change in resting angle from the intraoperative value. The mean change for the transvaginal tape was 25.74 degrees (27.43 to 3.28); Burch 11.18 degrees (-20.44 to -10.0) and fascia sling 13.9 degrees (26.57 to 15.68). The mean change in Q-tip angle was greater after transvaginal tape placement than after Burch ( p=0.000) and fascial sling ( p=0.022) procedures. These findings show that the resting position of the urethrovesical junction after surgery is different for all procedures. The transvaginal tape results in the greatest change in angle. This may help to negate the so-called 'tension-free' nature of the procedure. Surgeons need to be aware of this, as it may be an etiological factor in cases of late urinary retention and urethral erosion.

show abstract

“…No se han encontrado diferencias en los resultados en función de la edad, menopausia, obesidad, cirugías anti-incontinencia previas, tipo de anestesia y asociación a técnicas de reconstrucción del suelo pélvico [32][33][34][35][36][37][38][39][40][41][42][43][44][45] ; Jacquetin 46 refiere un mayor índice de retención post-operatoria en estas últimas pacientes.…”

Section: Comentariosunclassified

Utilidad de la determinación de la presión abdominal de fuga en el diagnóstico de la incontinencia de orina femenina en la época del TVT

et al. 2004

View full text Add to dashboard Cite

la incontinencia de esfuerzo tratada con TVT en función de la presión abdominal de fuga (PAF).MATERIAL Y MÉTODO: Estudio retrospectivo de 52 pacientes operadas entre 1999 y 2002 que tenían estudio urodinámico y determinación de la PAF, con seguimiento mínimo de 3 meses. Se analizan las características clínicas y resultados respecto de la desaparición de la incontinencia al esfuerzo como de la sensación subjetiva y satisfacción de las pacientes. Denominamos grupo 1 si la PAF>100; grupo 2 entre 61 y 100; y grupo 3 si la PAF<60.RESULTADOS: En el grupo 1 había 19 pacientes, 17 en el 2 y 16 en el 3. No existieron diferencias entre los 3 grupos respecto a la edad, paridad, menopausia, histerectomía, años de evolución, cirugía previa, presencia y grado de cistocele, asociación de colporrafia al TVT y tipo de anestesia utilizada. El grado clínico de Obrink aumentó a medida que disminuía la PAF (grado 3 en 26,32% del grupo 1; 31,58% del 2 y 68,71% del 3).La continencia al esfuerzo se consiguió en el 100% de las pacientes de los grupos 1 y 2, y en el 93,75% del grupo 3. La aparición de complicaciones, especialmente inestabilidad de novo o cuadros de urgencia-frecuencia así como la persistencia de inestabilidad en algunos casos de incontinencia mixta, hizo que el grado de satisfacción de las pacientes fuese del 79% en el grupo 1, 76,5% en el 2 y del 62,5% en el 3.CONCLUSIONES: La determinación de la PAF no parece influir en la decisión de implantar un TVT, pero sí permite diferenciar un grupo (PAF<60 cm de agua) cuyos resultados esperados son ligeramente peores.PALABRAS CLAVE: Incontinencia urinaria de esfuerzo. TVT. Presión abdominal de fuga. Uretropexia. ABSTRACT USEFULNESS OF ABDOMINAL LEAK POINT PRESSURE DETERMINATION IN THE DIAGNOSIS OF FEMALE URINARY INCONTINENCE IN THE TVT ERA OBJECTIVE:To analyse our results about continence in the treatment of female urinary incontinence with the tension-free vaginal tape (TVT) procedure based on abdominal leak point pressure (ALPP). PATIENTS AND METHODS:Retrospective study of the fifty two patients who had urodynamic study and abdominal leak point pressure determination and were operated on between 1999 and 2002 for stress urinary incontinence. We reviewed the data of clinical history, physical examination and urodynamic report, surgery, complications, and objective and subjective results. Those patients having ALPP>100 are included in group 1, between 61 and 100 in group 2 and less than 60 in group 3.RESULTS: There were 19 patients in group 1, 17 in group 2 and 16 in group 3. We found no difference between the three groups regarding age, delivery, menopause, hysterectomy, evolution, previous surgery, grade of cystocele, association of anterior colporraphy to TVT and type of anaesthesia. The Obrink clinical grade increased as the ALPP decreased (grade 3 in 26.32% of group 1, 31.58% in group 2 and 68.71% in group 3).100% of patients in groups 1 and 2 were continent with effort and 93.75% in group 3. Complications, especially de novo instability or urgency-frequency episodes or per...

show abstract

Evaluation of Tension–Free Vaginal Tape Procedure

Cited by 78 publications

References 8 publications

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

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

The position of the urethrovesical junction after incontinence surgery: early postoperative changes

Utilidad de la determinación de la presión abdominal de fuga en el diagnóstico de la incontinencia de orina femenina en la época del TVT

Contact Info

Product

Resources

About