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Tension-free vaginal tape (TVT) for the treatment of occult stress urinary incontinence in women undergoing prolapse repair: a prospective study of 100 consecutive cases.
Neurourol Urodyn. 2004; 23(7):632-5.NU

Abstract

AIMS

Clinically continent women with genitourinary prolapse and occult stress urinary incontinence (SUI) are considered to be at high risk of developing symptomatic SUI once the prolapse is repaired. We studied the efficacy and safety of tension-free vaginal tape (TVT) procedure in preventing postoperative SUI in these women.

METHODS

One hundred consecutive women (mean age 66.7 +/- 9.9 years) with significant genitourinary prolapse and occult SUI were prospectively enrolled. Preoperatively, none of the women complained of SUI. However, all had urodynamically-confirmed occult SUI, revealed by repositioning of the prolapse. Surgical intervention was comprised of transvaginal prolapse repair and prophylactic TVT procedure. Main outcome end points included operative morbidity, postoperative SUI, persistent or de novo urge incontinence, and voiding dysfunction.

RESULTS

The mean follow-up period was 27 months (range: 12-52 months). There was only one case of technique-related bladder perforation with no adverse outcome. Two other patients had postoperative urinary retention necessitating catheterization for more than 7 days, none of whom required any surgical intervention. Vaginal erosion of the tape was diagnosed in three patients, all of whom were successfully treated by excision of the eroded tape. Two (2%) patients developed urodynamically-confirmed SUI within 1 year postoperatively. However, postoperative urodynamics revealed asymptomatic sphincteric incontinence in 15 (15%) other patients. Thirteen (72%) of 18 patients with preoperative urge incontinence had postoperative persistent urge incontinence. De novo urge incontinence developed postoperatively in 8 (8%) patients.

CONCLUSIONS

TVT procedure is effective and safe in patients with occult SUI undergoing prolapse repair. Long-term durability of this procedure is yet to be established.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Urogynecology and Pelvic Floor Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel. agroutz@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15382184

Citation

Groutz, Asnat, et al. "Tension-free Vaginal Tape (TVT) for the Treatment of Occult Stress Urinary Incontinence in Women Undergoing Prolapse Repair: a Prospective Study of 100 Consecutive Cases." Neurourology and Urodynamics, vol. 23, no. 7, 2004, pp. 632-5.
Groutz A, Gold R, Pauzner D, et al. Tension-free vaginal tape (TVT) for the treatment of occult stress urinary incontinence in women undergoing prolapse repair: a prospective study of 100 consecutive cases. Neurourol Urodyn. 2004;23(7):632-5.
Groutz, A., Gold, R., Pauzner, D., Lessing, J. B., & Gordon, D. (2004). Tension-free vaginal tape (TVT) for the treatment of occult stress urinary incontinence in women undergoing prolapse repair: a prospective study of 100 consecutive cases. Neurourology and Urodynamics, 23(7), 632-5.
Groutz A, et al. Tension-free Vaginal Tape (TVT) for the Treatment of Occult Stress Urinary Incontinence in Women Undergoing Prolapse Repair: a Prospective Study of 100 Consecutive Cases. Neurourol Urodyn. 2004;23(7):632-5. PubMed PMID: 15382184.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tension-free vaginal tape (TVT) for the treatment of occult stress urinary incontinence in women undergoing prolapse repair: a prospective study of 100 consecutive cases. AU - Groutz,Asnat, AU - Gold,Ronen, AU - Pauzner,David, AU - Lessing,Joseph B, AU - Gordon,David, PY - 2004/9/24/pubmed PY - 2004/12/16/medline PY - 2004/9/24/entrez SP - 632 EP - 5 JF - Neurourology and urodynamics JO - Neurourol Urodyn VL - 23 IS - 7 N2 - AIMS: Clinically continent women with genitourinary prolapse and occult stress urinary incontinence (SUI) are considered to be at high risk of developing symptomatic SUI once the prolapse is repaired. We studied the efficacy and safety of tension-free vaginal tape (TVT) procedure in preventing postoperative SUI in these women. METHODS: One hundred consecutive women (mean age 66.7 +/- 9.9 years) with significant genitourinary prolapse and occult SUI were prospectively enrolled. Preoperatively, none of the women complained of SUI. However, all had urodynamically-confirmed occult SUI, revealed by repositioning of the prolapse. Surgical intervention was comprised of transvaginal prolapse repair and prophylactic TVT procedure. Main outcome end points included operative morbidity, postoperative SUI, persistent or de novo urge incontinence, and voiding dysfunction. RESULTS: The mean follow-up period was 27 months (range: 12-52 months). There was only one case of technique-related bladder perforation with no adverse outcome. Two other patients had postoperative urinary retention necessitating catheterization for more than 7 days, none of whom required any surgical intervention. Vaginal erosion of the tape was diagnosed in three patients, all of whom were successfully treated by excision of the eroded tape. Two (2%) patients developed urodynamically-confirmed SUI within 1 year postoperatively. However, postoperative urodynamics revealed asymptomatic sphincteric incontinence in 15 (15%) other patients. Thirteen (72%) of 18 patients with preoperative urge incontinence had postoperative persistent urge incontinence. De novo urge incontinence developed postoperatively in 8 (8%) patients. CONCLUSIONS: TVT procedure is effective and safe in patients with occult SUI undergoing prolapse repair. Long-term durability of this procedure is yet to be established. SN - 0733-2467 UR - https://www.unboundmedicine.com/medline/citation/15382184/Tension_free_vaginal_tape__TVT__for_the_treatment_of_occult_stress_urinary_incontinence_in_women_undergoing_prolapse_repair:_a_prospective_study_of_100_consecutive_cases_ L2 - https://doi.org/10.1002/nau.20068 DB - PRIME DP - Unbound Medicine ER -