Incidence and treatment of postoperative voiding dysfunction after the tension-free vaginal tape procedure.

Abstract

One of the most commonly experienced postoperative complications of the tension-free vaginal tape procedure (TVT) is voiding dysfunction (VD). The aim of this retrospective study was to evaluate our incidence of postoperative VD, our results after tape mobilisation, and whether demographic data could predict VD. A total of 715 women underwent a TVT procedure without concomitant operative procedures. In the case of persisting VD transvaginal tape mobilisation was performed up to 3 weeks postoperatively. The vaginal incision was reopened and downward extraction with a clamp was performed. Demographic data were investigated to predict postoperative VD. A total of 28 patients (3.9%) experienced VD. Seventeen patients (2.4%) underwent transvaginal tape mobilisation an average of 11.6 days (range 2-21) after the primary TVT procedure. No complications were observed in connection with the mobilisation. Eleven patients (1.5%) performed clean intermittent catheterisation (CIC) for a period of more than 1 day, with an average of 14.4 days (range 3-63). After tape mobilisation 16 women (94%) were relieved of their voiding dysfunction and were continent. One woman was somewhat incontinent after the procedure. Age, parity and previous caesarean section did not predict VD. Previous incontinence surgery might predict VD. The incidence of VD after the TVT procedure requiring tape mobilisation was 2.4%. Relief of the VD was obtained after tape mobilisation in all patients. Tape mobilisation is a safe and effective treatment for postoperative VD.