The Tension-Free Vaginal Tape Procedure for Female Urinary Incontinence Without Preoperative Urodynamic Evaluation

Laurikainen, Eija; Kiilholma, Pentti

doi:10.1016/s1072-7515(02)01904-x

Cited by 47 publications

(37 citation statements)

References 16 publications

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“…Similar results have been found in other studies [Meschia et al, 2001;Nilsson et al, 2001;Ward and Hilton, 2002;Laurikainen and Kiilholma, 2003]. …”

Section: Discussionsupporting

confidence: 92%

“…After 1 and 2 years, Debodinance et al [2002] found 91% and 83% of stress incontinent and 85% and 60% of mixed incontinent women to be cured, respectively. Laurikainen and Kiilholma [2003] found 97% of stress incontinent and 69% of mixed incontinent women to be cured. Objective cure and subjective cure Neurourology and Urodynamics DOI 10.1002/nau Signi¢cance level is given of changes from before to after operation.…”

Section: Discussionmentioning

confidence: 99%

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The tension free vaginal tape operation for women with mixed incontinence: Do preoperative variables predict the outcome?

Kulseng‐Hanssen

Husby

Schiøtz

2006

Neurourology and Urodynamics

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Aims: The aims of our study were (1) to investigate subjective and objective outcomes after tension free vaginal tape (TVT) operations in mixed incontinent women, (2) to detect if preoperative subjective and objective variables predict the outcome, and (3) to evaluate whether the surgical outcome is di¡erent for women who preoperatively ¢nd stress incontinence, urge incontinence, or urge and stress incontinence equally the predominant bother. Methods: A prospective cohort study was performed on 450 mixed incontinent women. A short-form disease-speci¢c validated questionnaire, 24-hr pad test, standardized stress test, residual urine, and maximum urinary £ow were used before and after a TVT operation. ''Cure'' was de¢ned as a condition where the women were very satis¢ed with the TVT operation and had negative stress-and 24 hr pad tests. Results: Preoperatively 69% had stress incontinence, 7% urge incontinence, and 24% urge and stress incontinence equally as the predominant bother. Cure rates were 80%, 52%, and 60%, respectively, in these groups. Postoperatively 43% of the women had no urge incontinence, while 49% were less, and only 8% were more bothered by urge incontinence. A higher preoperative urge incontinence index was correlated with signi¢cantly higher postoperative bother for all indices and leakage during 24-hr pad test. Conclusions: Mixed incontinent women with predominant stress incontinence had a better cure rate than those with predominant urge incontinence and those who were equally bothered by urge and stress incontinence. This point needs to be addressed when informing mixed incontinent women before a TVT operation. Neurourol. Urodynam. 26: 115^121, 2007. ß 2006

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“…Similar results have been found in other studies [Meschia et al, 2001;Nilsson et al, 2001;Ward and Hilton, 2002;Laurikainen and Kiilholma, 2003]. …”

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

The tension free vaginal tape operation for women with mixed incontinence: Do preoperative variables predict the outcome?

Kulseng‐Hanssen

Husby

Schiøtz

2006

Neurourology and Urodynamics

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“…Most preoperative parameters have been taken from the PE and UDS findings [12,13]. Many authors who have reported on which preoperative parameters can influence the outcome of surgery have included patients with mixed incontinence, who have OAB symptoms preoperatively.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Postoperative Voiding Dysfunction following Transobsturator Sling Procedures in Patients with Stress Urinary Incontinence

Cho

Song

et al. 2010

Int Neurourol J

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Purpose:We evaluated the influence of preoperative physical examination (PE) and urodynamic study (UDS) findings on objective postoperative bladder emptying, the subjective development of bladder storage symptoms, and patient-reported success of correction of stress urinary incontinence (SUI). Materials and Methods: From January 2007 to August 2008, a total of 159 female patients with SUI underwent transobturator midurethral sling surgery (TOT). The patients were selected for SUI, with no overactive bladder (OAB) symptoms, no detrusor overactivity (DO) on UDS, no pelvic organ prolapse, and no history of prior anti-incontinence surgery. Of these patients, 128 patients (aged 38-74 years; mean age, 51.8±7.1 years) with follow-up of at least 12 months were included in the analysis. All patients had PE and UDS findings, including Q-tip testing, free maximal flow rates (Qmax), filling cystometry, Valsalva leak point pressure, detrusor pressure at maximal flow, and maximal urethral closing pressure. The primary outcome was postoperative voiding dysfunction, defined as the subjective feeling of not empting one's bladder completely and a postvoid residual ≥100 ml. A secondary outcome, "cure" of SUI, was defined as "a negative result on the cough stress test and no subjective complaint of urine leakage." We analyzed the preoperative parameters by univariate and multivariate regression for voiding dysfunction, de novo OAB, cure rate, and the patients' satisfaction. Results: Patients with a preoperative Qmax < 15 ml/s (7 patients) had a tendency for postoperative voiding dysfunction compared with those with a Qmax 15 ml/s (15 patients) (35.0% vs. 13.9%, respectively; p=0.046). No other preoperative parameters had a statistically significant influence on postoperative voiding dysfunction. Receiver operating characteristic (ROC) analysis revealed that Qmax was a good predictor because the area under the ROC curve value of Qmax was 0.81 (95% CI: 0.73 to 0.89, p<0.001). The univariate and multivariate analysis of the preoperative PE and UDS parameters demonstrated that no significant differences and no independent risk factors were related to the postoperative de novo OAB, cure rate, or the patients' satisfaction. Conclusions: These findings suggest that preoperative UDS results, especially Qmax, could be used to predict postoperative voiding dysfunction after the TOT procedure.

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“…In an earlier Finnish study, the cure rates after incontinence surgery (TVT) among patients with SUI were 97% and 69% among patients with MUI [21]. Furthermore, a resent study confirmed the cure rate after TVT procedure better in women with predominant stress incontinence and those with stress and urge incontinence equally than those with predominant urge incontinence [22].…”

Section: Discussionmentioning

confidence: 89%

Transobturatoric tape procedure for female stress urinary incontinence

et al. 2008

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To assess the efficacy and safety of the transobturatoric tape (TOT) procedure as a treatment for female stress urinary incontinence (SUI). All patients (n=191) who underwent TOT between May 2003 and December 2004 were studied retrospectively. The study protocol involved recording of preoperative and perioperative details and postoperative subjective evaluation. The subjective outcome was assessed with two questionnaires at a mean of 20 and 34 months after the operation. The mean operation time of the patients without concomitant procedure was 19 min. The complication rate was low and postoperative recovery quick. The follow-up visit was scheduled 2-3 months after the procedure. The objective outcome assessment was done at the hospital for 50% of the patients, and the other half of the patients were followed up by their own gynecologist. During the follow-up visit (n=151), 79% of the women were cured: 90% of the patients with genuine SUI and 60% of those with mixed urinary incontinence (MUI). The data of 40 patients was either not available from patients' private gynecologists or the patients had not undergone a follow-up visit at all. For the first subjective outcome assessment, participating patients (n=188) received a questionnaire. Three patients had died from unrelated causes during this follow-up. The response rate was 82.4%. Overall, 83.9% of the respondents reported significant improvement, of which 90.5% of the patients had genuine SUI and 70.0% of the patients had MUI, respectively. During the second outcome assessment, the response rate was 85.1% (160/188). At a mean of 34 months postoperatively, 87.5% of the patients reported significant improvement: 94.5% of the patients with genuine SUI and 72.0% of those with MUI. The incontinence operation through the transobturatoric route is a safe and effective treatment, especially for patients with pure SUI. The rate of continence was sustained during a follow-up of 34 months.

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The Tension-Free Vaginal Tape Procedure for Female Urinary Incontinence Without Preoperative Urodynamic Evaluation

Cited by 47 publications

References 16 publications

The tension free vaginal tape operation for women with mixed incontinence: Do preoperative variables predict the outcome?

The tension free vaginal tape operation for women with mixed incontinence: Do preoperative variables predict the outcome?

Predictors of Postoperative Voiding Dysfunction following Transobsturator Sling Procedures in Patients with Stress Urinary Incontinence

Transobturatoric tape procedure for female stress urinary incontinence

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