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Surgical complications and medium-term outcome results of tension-free vaginal tape: a prospective study of 313 consecutive patients.
Neurourol Urodyn. 2004; 23(1):7-9.NU

Abstract

OBJECTIVE

A prospective study was undertaken to examine the incidence of surgical complications and medium-term outcomes of tension-free vaginal tape (TVT) surgery in a large, heterogeneous group of stress-incontinent women.

METHODS

Surgery was tailored according to preoperative clinical and urodynamic findings: stress-incontinent women underwent TVT surgery, whereas those with concomitant urogenital prolapse underwent combined TVT and prolapse repair. Post-operatively the patients were scheduled for evaluation at 1, 3, 6, and 12 months, and annually thereafter. All underwent urodynamics at 3 months post-operatively.

RESULTS

Three hundred and thirteen consecutive patients were prospectively studied. The mean follow-up period was 21.4 +/- 13.5 months. Sixteen (5.1%) cases of intravesical passage of the prolene tape occurred in our series, two of which were diagnosed at 3 and 15 months post-operatively. Eight (2.5%) patients had post-operative voiding difficulties, necessitating catheterization for more than 7 days. However, transvaginal excision of the tape was required in one case only. Vaginal erosion of the tape was diagnosed in four (1.3%) patients, all of whom were successfully treated by local excision of the eroded tape. Outcome analysis was restricted to 241 consecutive patients with at least 12 months of follow-up. Subjectively, 16 (6.6%) patients had persistent mild stress urinary incontinence, although urodynamics revealed asymptomatic sphincteric incontinence in 17 (7%) other patients. De-novo urge incontinence developed post-operatively in 20 (8.3%) patients.

CONCLUSIONS

The TVT procedure is associated with good medium-term cure rates, however, it is not free of troublesome complications and the patients should be informed accordingly. Only well-trained surgeons, familiar with pelvic anatomy, surgical alternatives, and endoscopic techniques should perform the operation.

Authors+Show Affiliations

Urogynecology and Pelvic Floor Unit, Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

14694449

Citation

Levin, Ishai, et al. "Surgical Complications and Medium-term Outcome Results of Tension-free Vaginal Tape: a Prospective Study of 313 Consecutive Patients." Neurourology and Urodynamics, vol. 23, no. 1, 2004, pp. 7-9.
Levin I, Groutz A, Gold R, et al. Surgical complications and medium-term outcome results of tension-free vaginal tape: a prospective study of 313 consecutive patients. Neurourol Urodyn. 2004;23(1):7-9.
Levin, I., Groutz, A., Gold, R., Pauzner, D., Lessing, J. B., & Gordon, D. (2004). Surgical complications and medium-term outcome results of tension-free vaginal tape: a prospective study of 313 consecutive patients. Neurourology and Urodynamics, 23(1), 7-9.
Levin I, et al. Surgical Complications and Medium-term Outcome Results of Tension-free Vaginal Tape: a Prospective Study of 313 Consecutive Patients. Neurourol Urodyn. 2004;23(1):7-9. PubMed PMID: 14694449.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Surgical complications and medium-term outcome results of tension-free vaginal tape: a prospective study of 313 consecutive patients. AU - Levin,Ishai, AU - Groutz,Asnat, AU - Gold,Ronen, AU - Pauzner,David, AU - Lessing,Joseph B, AU - Gordon,David, PY - 2003/12/25/pubmed PY - 2004/4/22/medline PY - 2003/12/25/entrez SP - 7 EP - 9 JF - Neurourology and urodynamics JO - Neurourol Urodyn VL - 23 IS - 1 N2 - OBJECTIVE: A prospective study was undertaken to examine the incidence of surgical complications and medium-term outcomes of tension-free vaginal tape (TVT) surgery in a large, heterogeneous group of stress-incontinent women. METHODS: Surgery was tailored according to preoperative clinical and urodynamic findings: stress-incontinent women underwent TVT surgery, whereas those with concomitant urogenital prolapse underwent combined TVT and prolapse repair. Post-operatively the patients were scheduled for evaluation at 1, 3, 6, and 12 months, and annually thereafter. All underwent urodynamics at 3 months post-operatively. RESULTS: Three hundred and thirteen consecutive patients were prospectively studied. The mean follow-up period was 21.4 +/- 13.5 months. Sixteen (5.1%) cases of intravesical passage of the prolene tape occurred in our series, two of which were diagnosed at 3 and 15 months post-operatively. Eight (2.5%) patients had post-operative voiding difficulties, necessitating catheterization for more than 7 days. However, transvaginal excision of the tape was required in one case only. Vaginal erosion of the tape was diagnosed in four (1.3%) patients, all of whom were successfully treated by local excision of the eroded tape. Outcome analysis was restricted to 241 consecutive patients with at least 12 months of follow-up. Subjectively, 16 (6.6%) patients had persistent mild stress urinary incontinence, although urodynamics revealed asymptomatic sphincteric incontinence in 17 (7%) other patients. De-novo urge incontinence developed post-operatively in 20 (8.3%) patients. CONCLUSIONS: The TVT procedure is associated with good medium-term cure rates, however, it is not free of troublesome complications and the patients should be informed accordingly. Only well-trained surgeons, familiar with pelvic anatomy, surgical alternatives, and endoscopic techniques should perform the operation. SN - 0733-2467 UR - https://www.unboundmedicine.com/medline/citation/14694449/Surgical_complications_and_medium_term_outcome_results_of_tension_free_vaginal_tape:_a_prospective_study_of_313_consecutive_patients_ DB - PRIME DP - Unbound Medicine ER -