CONCOMITANT VAGINAL SURGERY DID NOT AFFECT OUTCOME OF THE TENSION-FREE VAGINAL TAPE OPERATION DURING A PROSPECTIVE 3-YEAR FOLLOWUP STUDY

Abstract

We compare outcomes when vaginal surgery and a tension-free vaginal tape (TVT) operation were done concomitantly and when only a TVT operation was done in patients with stress or mixed urinary incontinence. Outcomes in 75 consecutive patients who underwent a TVT operation concomitantly with vaginal surgery (group 1) were compared with outcomes in 75 who underwent only a TVT operation (group 2) between August 1998 and June 2000. Group 2 patients were matched for age and incontinence type with group 1 patients. All study subjects had a followup visit to the study hospital 2 months after the operation. Questionnaire based assessments were done 2 and 3 years after the operation. Ten group 1 (13%) and 6 group 2 (8%) patients had a lower urinary tract infection. Other infections occurred after operation in 10 group 1 (13%) and 1 group 2 (1.3%) patients. Four cases (5.3%) of intraoperative bladder perforation occurred in group 1. A total of 15 group 1 (20%) and 7 group 2 (9.3%) patients were treated for transient urinary retention. Two months after the operation 93% of group 1 and 97% of group 2 were free of stress urinary incontinence. The corresponding percents 2 years after operation were 88% and 93%, and at 3 years they were 87% and 92%, respectively. Complications and transient urinary retention occurred more often after TVT operations and concomitant vaginal surgery than after the TVT operation alone. There were no statistically significant differences in regard to the cure of stress urinary incontinence and incidence of urge symptoms during the 3-year followup.