The Results of the Tension-Free Vaginal Tape Procedure for the Treatment of Stress Urinary Incontinence

Abstract

OBJECTIVE: To report our experiences in using tension-free vaginal tape (TVT) procedure as a primary treatment of type II or type III of female stress urinary incontinence. MATERIALS AND METHODS: Twenty women with urodynamically confirmed stress urinary incontinence underwent TVT procedure. A multichannel urodynamic study with Valsalva leak point pressure was used to classify the types of stress urinary incontinence. Of the 20 patients, 8 (40%) were diagnosed with type III incontinence, 8 (40%) with type II/III, and 4 (20%) with type II. Three patients had a past history of pelvic surgery; none had undergone anti-incontinence surgery. RESULTS: The mean age of the women was 61.0±10.4 years (range: 34-74). Seventeen (85%) were completely cured, 2 (10%) were improved, and 1 (5%) failed to improve. The average follow-up was 18.7±5.3 months (range: 10-28). The subjective success rate was 95% (cure and improvement). Intraoperative bladder penetration occurred in 2 patients (10%). One patient (5%) had post-operative urinary retention and continued clean intermittent self-catheterization. Two patients (10%) developed de novo urgency: 1 (5%) had persistent urgency and the other had a vaginal wound infection (5%). There was no tape rejection and blood loss was rare. CONCLUSIONS: The tension-free vaginal tape procedure is a minimally invasive surgery. It can be used as an effective and safe procedure for treatment of type II or type III female stress urinary incontinence. But further long-term studies are necessary for cases with intrinsic sphincter deficiency or those who had failed anti-incontinence surgery.