Seven-Year Follow-Up of the Tension-Free Vaginal Tape Procedure for Treatment of Urinary Incontinence

Department of Obstetrics and Gynaecology, University of Helsinki, Helsinki, Uusimaa, Finland
Obstetrics and Gynecology (Impact Factor: 5.18). 01/2005; 104(6):1259-62. DOI: 10.1097/01.AOG.0000146639.62563.e5
Source: PubMed


To evaluate the long-term cure rates and late complication rates after treatment of female urinary stress incontinence with the minimally invasive tension-free vaginal tape operation.
Prospective observational, 3-center cohort study originally of 90 women requiring surgical treatment for primary urinary stress incontinence. Assessment variables included a 24-hour pad weighing test, a stress test, visual analog scale for assessing the degree of bother, and a questionnaire assessing the subjective perception of the women on their continence status.
The follow-up time was a mean of 91 months (range 78-100 months). Both objective and subjective cure rates were 81.3% for the 80 women available for follow-up. Asymptomatic pelvic organ prolapse was found in 7.8%, de novo urge symptoms in 6.3%, and recurrent urinary tract infection in 7.5% of the women. No other long-term adverse effects of the procedure were detected.
The tension-free vaginal tape procedure for treatment of female urinary stress incontinence is effective over a period of 7 years.

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    • "The long-term cure rate of TVT was previously shown to be between 71% and 86% [14-16]. Nilsson et al. [17] performed a follow-up of 80 patients for 7 years and reported an 81.3% cure rate. However, the TVT procedure has associated complications such as bladder injury, bowel perforation, necrotizing fasciitis, and large blood vessel injury [18,19]. "
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    ABSTRACT: We evaluated the long-term outcome of a readjustable midurethral sling system (Remeex) in the treatment of recurrence of stress urinary incontinence (SUI) after surgical treatment or SUI with intrinsic sphincter deficiency (ISD). This study included 19 patients who underwent the Remeex procedure with a mean of 45.6 months of follow-up. The patients had responded to a telephone questionnaire. Thirteen patients had ISD, four patients had SUI recurrence, and two patients had both. The questionnaire included subjective cure and satisfaction surveys and also recommended surgery to some patients. The mean patient age was 69.1 years (range, 50-85 years), the mean parity was 2.79 times (range, 2-5 times), and the mean follow-up period was 45.6 months (range, 21-72 months). The long-term follow-up cure rate was 79%, the improvement rate was 21%, and the fail rate was 0%. The long-term follow-up "very satisfactory" rate was 26.3%, the "satisfactory" rate was 73.7%, and the "usual" and "unsatisfactory" rates were both 0%. In addition to these results, 16 patients (84.2%) would recommend the Remeex procedure to other patients with SUI recurrence or ISD. After the procedure, four patients had urinary retention, three patients had difficulty emptying, and one patient had SUI recurrence. Furthermore, all of the patients subsequently endured sling readjustments. After long-term follow-up, the Remeex system showed good cure rates and subjective satisfaction rates that were similar to the results found at the 1-year follow-up, and minimal complications were reported. Therefore, the Remeex system is effective in treating patients with SUI recurrence or ISD.
    Korean journal of urology 02/2014; 55(2):124-8. DOI:10.4111/kju.2014.55.2.124
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    • "Treatment of stress urinary incontinence (SUI) caused by urethral hypermobility or intrinsic sphincter deficiency with urethral sling procedures may yield up to a 80-90% success rate depending on the definition of success. (Nilsson et al. 2001; Liapis et al. 2002; Rodriguez & Raz 2003; Nilsson et al. 2004; Ward & Hilton 2004) In a minority of patients, however, there is persistence or worse incontinence after surgical therapy. In the general population, risk factors for midurethral sling (MUS) failure are BMI >25, mixed incontinence, intrinsic sphincter deficiency, diabetes mellitus, advanced patient age >75 years old and prior continence surgery. "

    Urinary Incontinence, 04/2012; , ISBN: 978-953-51-0484-1
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    • "Following the initial reports by Ulmsten et al. [2] on a new surgical procedure to treat SUI, the TVT procedure gained worldwide diffusion due both to its mini-invasiveness and to its high success rates. Through assessment by use of strict objective and subjective outcome measures, cure rates of 85% have been reported, with another 5 to 10% showing significant improvement [9], and preliminary analysis of the 7-year results of Nilsson et al. [10] indicates a cure rate of 81%. "
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    ABSTRACT: Transobturator approaches to midurethral sling surgery are one of the most commonly performed operations for female stress urinary incontinence throughout the world. However, very few results of randomized clinical trials of transobturator midurethral sling surgery (MONARC vs. TVT-O) for the treatment of female urinary incontinence have been reported. In this study, we compared the 3-year follow-up cure rates of these two procedures. From July 2006 to June 2008, 74 patients who had undergone MONARC (35 patients) or TVT-O (39 patients) were included in the study and were analyzed prospectively. The mean follow-up duration of both groups was 39.2 months. Preoperative and postoperative evaluations included physical examination, uroflowmetry and postvoid residual measurement, involuntary urine loss with physical activity, and urinary symptoms. Cure of female urinary incontinence was defined as patient report of no loss of urine upon physical activity. The patients' satisfaction after treatment was rated as very satisfied, satisfied, equivocal, and unsatisfied. Very satisfied and satisfied were considered as the satisfied rate. There were no significant differences in preoperative patient characteristics, postoperative complications, or success rate between the two groups. The cure rate of the MONARC and TVT-O groups was 85.7% and 84.6%, respectively. The patient satisfaction (very satisfied, satisfied) rate of the MONARC and TVT-O groups was 82.8% and 82.1%, respectively. The MONARC and TVT-O procedures were equally efficient for the treatment of female urinary incontinence, with maintenance of high cure rates for 3 years. Longer follow-up is needed to confirm these results.
    Korean journal of urology 04/2012; 53(4):258-62. DOI:10.4111/kju.2012.53.4.258
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