Prevalence of Persistent and De Novo Overactive Bladder Symptoms After the Tension-Free Vaginal Tape

Segal, Jeffrey L.; Vassallo, Brett J.; Kleeman, Steven D.; Silva, W Andre; Karram, Mickey M.

doi:10.1097/01.aog.0000147596.44421.72

Cited by 129 publications

(74 citation statements)

References 25 publications

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“…Urinary retention is the most commonly reported complication with a range of 4-43%. De novo urinary urgency and bladder perforation were reported in 4.3-34% and 0-10%, respectively [13][14][15][16][17][18][19] . In this study, voiding difficulty after TVT was found in 29.5, 13.1, 9.8, and 9.8% at 1, 3, 6, and 12 months postoperatively, respectively, and was the most common complication.…”

Section: Discussionmentioning

confidence: 99%

Surgical Therapeutic Index of Tension-Free Vaginal Tape and Transobturator Tape for Stress Urinary Incontinence

Jeon¹,

Chung²,

Park³

et al. 2007

Gynecol Obstet Invest

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Background/Aims: The aim of this study was to obtain the surgical therapeutic index (STI) of tension-free vaginal tape (TVT) and transobturator tape (TOT) and compare it with the previously obtained result of Burch colposuspension. Methods: The study population consisted of 121 patients who were diagnosed as having stress urinary incontinence, underwent TVT or TOT between January 1, 2000 and June 30, 2005 and were followed up for at least 1 year. Patients with detrusor overactivity, urinary tract infection, intrinsic sphincter deficiency and pelvic organ prolapse more than stage II according to the POP-Q system were excluded. The cure and complication rates were investigated, and the STI (median percent cure rate/median percent complication rate) of each operation was calculated. Results: Of the 121 patients, 61 underwent TVT and 60 received TOT. Patient characteristics and the results of preoperative urodynamic studies showed no significant difference between the two groups. The STI of TOT (2.72, 4.08, 4.23, 5.29) was higher than that of Burch colposuspension (1.19, 2.27, 2.89, 3.53) and TVT (2.77, 3.69, 3.23, 3.17) irrespective of follow-up months (at 1, 3, 6, 12 months). Conclusion: TOT seems to be a more suitable surgical procedure for stress urinary incontinence with urethral hypermobility.

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Section: Discussionmentioning

confidence: 99%

Surgical Therapeutic Index of Tension-Free Vaginal Tape and Transobturator Tape for Stress Urinary Incontinence

Jeon¹,

Chung²,

Park³

et al. 2007

Gynecol Obstet Invest

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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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“…In addition, the micturition frequency and the number of nocturia were significantly improved in the frequency volume chart analysis. Segal et al [17] have reported that the development of de novo urgency in 4.3% and de novo incontinence in 9.1% occurred after surgery in pure stress incontinence patients. Also, the results of other investigators have shown the improvement of the OAB symptom in 50-60% of patients after TVT operation and the low manifestation of de novo urge symptom [17][18][19].…”

Section: Discussionmentioning

confidence: 99%

“…Segal et al [17] have reported that the development of de novo urgency in 4.3% and de novo incontinence in 9.1% occurred after surgery in pure stress incontinence patients. Also, the results of other investigators have shown the improvement of the OAB symptom in 50-60% of patients after TVT operation and the low manifestation of de novo urge symptom [17][18][19]. Therefore, our result of IVS procedure improving OAB symptom is considered to be relatively high or comparable to other procedures, although limited numbers of data are suggested.…”

Section: Discussionmentioning

confidence: 99%

A safety and quality of life analysis of intravaginal slingplasty in female stress incontinence: a prospective, open label, multicenter, and observational study

et al. 2007

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This prospective, open label, multicenter, and observational study was performed to determine the efficacy, safety, and the impact of this procedure on the current quality of life (QOL). One hundred three women underwent the intravaginal slingplasty (IVS) procedure. (74/83) cure rate. During follow-up period, one patient (1.2%) has presented with vaginal erosion of the sling material. The I-QOL showed significant improvement in total and three subscale scores at 12 months of follow-up period. This study demonstrated that the IVS procedure provides a safe and effective means for the treatment of female stress incontinence and improvement of QOL.

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Prevalence of Persistent and De Novo Overactive Bladder Symptoms After the Tension-Free Vaginal Tape

Abstract: The proportion of patients in whom de novo overactive bladder or urge incontinence symptoms developed postoperatively is low, and approximately 57% of patients with preoperative overactive bladder symptoms can expect resolution of these symptoms after a TVT.

Cited by 129 publications

References 25 publications

Surgical Therapeutic Index of Tension-Free Vaginal Tape and Transobturator Tape for Stress Urinary Incontinence

Surgical Therapeutic Index of Tension-Free Vaginal Tape and Transobturator Tape for Stress Urinary Incontinence

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

A safety and quality of life analysis of intravaginal slingplasty in female stress incontinence: a prospective, open label, multicenter, and observational study

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