Long-Term Results With Tension-Free Vaginal Tape on Mixed and Stress Urinary Incontinence

Holmgren, Corinne; Nilsson, Staffan; Lanner, Lars; Hellberg, Dan

doi:10.1097/01.aog.0000167393.95817.dc

Cited by 146 publications

(109 citation statements)

References 15 publications

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“…Another limitation of our study is the mean length of follow-up for subjective UUI symptoms. One study indicates that UUI symptoms return 4 years after TVT procedures, so with time; the bene¢ts of midurethral slings for UUI may decrease [Holmgren et al, 2005]. Future long-term studies are needed to con¢rm the long-term bene¢ts of midurethral sling surgery on UUI.…”

Section: Discussionmentioning

confidence: 99%

Detrusor overactivity and urge urinary incontinence following trans obturator versus midurethral slings

Botros

Miller

Goldberg

et al. 2006

Neurourology and Urodynamics

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Aims: To compare the rates of resolution of detrusor overactivity (DO) and subjective urge urinary incontinence (UUI) as well as de novo DO and UUI between the Monarc, TVT, and SPARC midurethral sling procedures. Methods: Two hundred and seventy-six subjects with urodynamic stress or mixed urinary incontinence underwent retropubic midurethral slings (TVT, N ¼ 99; SPARC, N ¼ 52) or transobturator slings (Monarc, N ¼ 125). All evaluable subjects had a routine o⁄ce evaluation, subjective assessment of UUI, and multichannel urodynamic testing pre-and 3 months postoperatively. Comparisons were made using Student's t-test, ANOVA, McNemar's test, and Chi-Square test where appropriate. Multivariate logistic regression was performed to detect possible confounding factors such as sling type, and di¡erences in concomitant surgical procedures. Results: De novo subjective UUI di¡ered signi¢cantly between the Monarc and the other two slings (33% TVT vs. 8% Monarc vs. 17% SPARC, P ¼ 0.04). Fourteen to Sixteen percents of patients with preoperative UUI who underwent TVT or SPARC had worsening of their UUI symptoms while only 6% of the Monarc group did (P ¼ 0.02). There was no di¡erence in rates of resolution of DO among the three groups (40% vs. 48% vs. 32%, P ¼ 0.39) or de novo DO (32% vs. 22% vs. 22%, P ¼ 0.64) at 3 months. Conclusions: Patients who undergo transobturator procedures have signi¢-cantly lower rates of de novo UUI than those who undergo midurethral sling procedures. Rates of resolution of DO, UUI, and de novo DO do not di¡er between groups. Neurourol. Urodynam. 26:42^45, 2007. ß 2006

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Section: Discussionmentioning

confidence: 99%

Detrusor overactivity and urge urinary incontinence following trans obturator versus midurethral slings

Botros

Miller

Goldberg

et al. 2006

Neurourology and Urodynamics

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“…5 A growing number of randomized controlled studies have shown the TVT procedure to have results similar to traditional Burch colposuspension. [6][7][8][9][10] However, very few data exist concerning long-term results [11][12][13] and quality of life after TVT placement, and there are concerns regarding postoperative voiding dysfunction or urgencies. [14][15][16] In this study, we present the results of a study on the long-term outcome of the TVT procedure assessed with symptoms and quality-of-life questionnaires.…”

Section: Introductionmentioning

confidence: 99%

Long‐term results of tension‐free vaginal tape for female urinary incontinence: Follow up over 6 years

et al. 2007

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Objective: To describe the long-term outcome of using tension-free vaginal tape (TVT) with and without associated procedures. Methods: A questionnaire was mailed to a population of 61 women who had undergone TVT surgery more than 6 years ago. Of this population, 41 (80%) had suffered from stress urinary incontinence (SUI). The questionnaire included questions about urinary symptoms, satisfaction and quality of life. The questionnaire was answered by 51 of the 61 women. Results: Mean follow up was 83 months. The women with SUI had a persistent cure rate of 80% with a satisfaction rate of 97%. The cure rate after 6 years was 37% in women with mixed incontinence. Concomitant hysterectomy (relative risks = 0.87) and body mass index (BMI) do not alter the long-term results of TVT procedure. Peroperative bladder injury is not associated with an increased risk of long-term lower urinary tract symptoms (LUTS) or with a decreased satisfaction rate (relative risks = 0.85). Conclusions: Concomitant hysterectomy, increased BMI and bladder injury do not alter good long-term results of TVT.

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“…Surgical intervention for SUI has been shown to improve or resolve the symptoms of OAB in women with mixed incontinence [Chou et al, 2003;Segal et al, 2004]. Despite this, up to 40% of women will continue to experience persistent and bothersome OAB symptoms, which may increase with longer follow-up [Segal et al, 2004;Holmgren et al, 2005].…”

Section: Introductionmentioning

confidence: 99%

Management of refractory urinary urge incontinence following urogynecological surgery with sacral neuromodulation

Starkman

Wolter

Scarpero

et al. 2006

Neurourology and Urodynamics

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Aims: We sought to explore our patient outcomes utilizing sacral neuromodulation in the management of refractory urinary urge incontinence following urogynecological surgical procedures. Methods: A total of 25 women with urinary urge incontinence following urogynecological surgery were selected for SNS therapy and retrospectively analyzed. All patients completed a comprehensive urological evaluation. Clinical data was recorded to determine outcomes and identify parameters that would be predictive of response to neuromodulation. Outcomes were determined via subjective patient questionnaire and graded as follows: signi¢cant response (80% improvement), moderate response (50% and <80% improvement), and poor response (<50% response). Results: Nineteen patients had a previous pubovaginal sling (10 with concomitant pelvic prolapse repair), 3 a previous retropubic suspension, and 3 a transperitoneal vesicovaginal ¢stula repair. Urethrolysis was performed in 4 patients to alleviate bladder outlet obstruction prior to sacral neuromodulation. Mean patient age was 59.8 years and length of follow-up was 7.2 months. Twenty-two women (88%) had the IPG placed during a Stage 2 procedure. Twenty patients maintained at least a 50% improvement in clinical symptoms at last follow-up and 6 patients were continent. Overall, the number of pads/day improved from 4.2 to 1.1 (P < 0.001). There were no signi¢cant di¡erences in response to neuromodulation based upon age, duration of symptoms, type of surgery, or urodynamic parameters. Conclusion: Sacral neuromodulation appears to be an e¡ec-tive therapy in patients with refractory urge incontinence following urogynecological surgery. Larger prospective studies with longer follow-up are needed to assess the durability of this therapeutic modality. Neurourol. Urodynam. 26: 29^35, 2007. ß 2006

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Long-Term Results With Tension-Free Vaginal Tape on Mixed and Stress Urinary Incontinence

Abstract: III.

Cited by 146 publications

References 15 publications

Detrusor overactivity and urge urinary incontinence following trans obturator versus midurethral slings

Detrusor overactivity and urge urinary incontinence following trans obturator versus midurethral slings

Long‐term results of tension‐free vaginal tape for female urinary incontinence: Follow up over 6 years

Management of refractory urinary urge incontinence following urogynecological surgery with sacral neuromodulation

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