Tension-free vaginal tape: a prospective subjective and objective outcome analysis

Richter, Holly E.; Norman, Andy M.; Burgio, Kathryn L.; Goode, Patricia S.; Wright, Kate Clark; Benton, J.; Varner, R. Edward

doi:10.1007/s00192-004-1238-5

Cited by 22 publications

(5 citation statements)

References 19 publications

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“…A previous study reported on the assessment of 87 patients using a Patient Satisfaction Questionnaire (PSQ) at 24 months postoperatively [21]. That study found that 95.5% of patients were somewhat or completely satisfied with their progress, and that the majority of patients were satisfied despite the presence of irritating voiding symptoms.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2010

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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.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2010

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“…In 1 study of 809 women who underwent tension-free vaginal tape procedures for SUI, UDI-6 scores decreased by 60.3% (from 58% to 23%) and IIQ-7 scores decreased by 79.3% (from 58% to 12%) at 6 months postoperatively 42 . In another study of 87 women who underwent tension-free vaginal tape procedures, UDI-6 scores decreased by 64.6% (from 61.8% to 21.9%) and IIQ-7 scores decreased by 75.1% (from 51.1% to 12.7%) at 1-month follow-up 43 . This does not suggest that both therapies are equally efficacious, but reductions in standardized questionnaire scores noted for both treatments show that each offers some therapeutic benefit and symptom relief for patients.…”

Section: Discussionmentioning

confidence: 95%

The Role of Pessaries in the Treatment of Women With Stress Urinary Incontinence: A Systematic Review and Meta-Analysis

Klein

Stoddard

Rardin

et al. 2022

Female Pelvic Med Reconstr Surg

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ImportancePessaries are an important conservative therapy for stress urinary incontinence (SUI), but few studies have comprehensively evaluated their utility.ObjectiveThe objective of this study is to evaluate the existing evidence on the efficacy and safety of pessaries for the treatment of SUI.Study DesignWe searched for the terms “stress urinary incontinence” and “pessar/y/ies/ium” in PubMed, Embase, and Cinhal on June 10, 2020. Studies that characterized subjective and/or objective data were included. Studies performed in pediatric populations, pregnancy, and use of pessaries not for SUI were excluded. Two reviewers independently screened and assessed data quality and risk of bias according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.ResultsTen studies, including 376 patients, were included. In terms of subjective outcomes, 76% of 72 patients reported feeling continent after pessary treatment compared with 0% of 86 patients surveyed before pessary use (P < 0.0001). Both Urinary Distress Inventory and Incontinence Impact Questionnaire scores decreased significantly by 46.7% (n = 155 baseline, n = 139 follow-up; P < 0.0001) and 67.8% (n = 139 baseline, n = 107 follow-up; P < 0.0001), respectively. Significant objective measures associated with pessary use included increased urethral closure pressure (n = 122; g = 0.56; 95% confidence interval [CI], −0.66 to 1.77; P < 0.049) and decreased pad weight (n = 129 baseline; n = 118 follow-up; g = −0.89; 95% CI, −1.986 to 0.19; P = 0.009). Adverse events significantly decreased at greater than 6 months follow-up compared with less than 6 months follow-up, including pain (31.5%, n = 29/92 vs 14.3%, n = 5/35; P = 0.0513) and discomfort (50%, n = 46/92 vs 29.3%, n = 12/41; P = 0.0268).ConclusionsBased on both subjective and objective measures, pessaries are an effective conservative treatment option for SUI. This supports pessary use, though larger studies with longer-term follow-up are warranted.

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“…Most reports support roughly a 70% to 80% improvement that is sustained over time. 2,12,13 Analysis of the SISTEr trial comparing Burch vs. Sling showed a 78% improvement after both procedures, maintained up to 2 years. 13 …”

Section: Discussionmentioning

confidence: 96%

Condition-Specific Quality of Life 24 Months After Retropubic and Transobturator Sling Surgery for Stress Urinary Incontinence

Sirls¹,

Tennstedt

Lukacz

et al. 2012

Female Pelvic Medicine &Amp; Reconstructive Surgery

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Aims To compare quality of life (QoL) and factors associated with QoL change after retropubic (RMUS) and transobturator (TMUS) midurethral slings using the Incontinence Impact Questionnaire, (IIQ) and the International Consultation on Incontinence Questionnaire (ICIQ). Methods Five hundred ninety seven women in a multicenter randomized trial of RMUS vs. TMUS were examined. The IIQ and ICIQ were obtained at baseline, 12 and 24 months. Repeated measures analysis of variance tested for differences by treatment group over time. Multivariable analysis identified factors associated with QoL change at 12 months post- operative, controlling for treatment group and baseline QoL. Results Improvement in IIQ was associated with: treatment success, younger age, improvement in stress incontinence (SUI) symptom severity and bother (all p < 0.05). Improvement in ICIQ was associated with treatment success, younger age, improvement in SUI symptom severity and bother, lower body mass index and no re-operation (all p < 0.05). Improvement of the IIQ was stable over time (p =0.35) for both treatment groups (p=0.66) whereas the ICIQ showed a small but clinically insignificant decline (p=0.03) in both treatment groups (p=0.51). Conclusions Postoperative QOL was improved after RMUS and TMUS. Measures of QOL functioned similarly, although more surgically modifiable urinary incontinence factors predicted improvement with the IIQ.

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Tension-free vaginal tape: a prospective subjective and objective outcome analysis

Cited by 22 publications

References 19 publications

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

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

The Role of Pessaries in the Treatment of Women With Stress Urinary Incontinence: A Systematic Review and Meta-Analysis

Condition-Specific Quality of Life 24 Months After Retropubic and Transobturator Sling Surgery for Stress Urinary Incontinence

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