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[Three-year outcomes of the tension-free vaginal tape procedure for treatment of female stress urinary incontinence with low urethral closure pressure].
Gynecol Obstet Fertil. 2006 Sep; 34(9):692-700.GO

Abstract

OBJECTIVE

The aim of this study was to assess, with long-term outcome, the effectiveness of TVT for stress urinary incontinence (SUI) with low maximum urethral closure pressure (MUCP) and to identify predicting factors for failure in this case.

PATIENTS AND METHODS

This is a bicentric retrospective study including women who underwent a TVT procedure for grade 3-SUI according to the Ingelman-Sundberg's scale. All patients had a low MCUP defined by PCUM < 30 or by the formula 110-the age+/-20% cmH2O. Urethral hypermobility was defined on physical examination and urodynamic investigations. TVT was the only operation performed. Patients were assessed at three months then at longer term with an average follow-up of three years and ever less than one year.

RESULTS

A total of 60 women 30 to 78 years old (mean age 55) were so operated. More than third of them (38%) had already been operated for incontinence. Thirty-eight percent had SUI without urethral hypermobility. Thirty percent presented bladder overactivity. The short-term evaluation found that, out of 58 patients, 70,6% cured, 10,3% improved and 18,9% classified as failure. The long-term evaluation, concerning 44 patients, found that 57% remained cured, 16% improved and 27% were classified as failure. Bladder overactivity was cured or improved in more than half of the cases (60%). Ten percent of de novo urgencies were noted, all of which persisted later on. For all that, as much as two thirds of these patients were satisfied with the TVT. Mean age of patients classified as failure, was higher (65 years). Previous SUI surgery did not modify the results. When the MUCP was < 20 cmH2O, success was present only one time out of two. The absence of urethral hypermobility decreased to a significant degree the probability of cure (38 vs. 82,6%, P < 0.01), and more still when bladder overactivity was associated (16,6 vs. 66,6%, P < 0.01). Postoperative voiding troubles constituted a pejorative factor for success of surgery.

DISCUSSION AND CONCLUSION

Even if results of TVT with low MCUP are worse, they do not remain less appreciable. When we confront the benefits awaited with this technique compared to the usually described complications, TVT must represent the first treatment of this indication.

Authors+Show Affiliations

Service de gynécologie-obstétrique, pavillon Mère-Enfant, hôpital Charles-Nicolle, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France. fabrice.sergent@chu-rouen.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

fre

PubMed ID

16949853

Citation

Sergent, F, et al. "[Three-year Outcomes of the Tension-free Vaginal Tape Procedure for Treatment of Female Stress Urinary Incontinence With Low Urethral Closure Pressure]." Gynecologie, Obstetrique & Fertilite, vol. 34, no. 9, 2006, pp. 692-700.
Sergent F, Popovic I, Grise P, et al. [Three-year outcomes of the tension-free vaginal tape procedure for treatment of female stress urinary incontinence with low urethral closure pressure]. Gynecol Obstet Fertil. 2006;34(9):692-700.
Sergent, F., Popovic, I., Grise, P., Leroi, A. M., & Marpeau, L. (2006). [Three-year outcomes of the tension-free vaginal tape procedure for treatment of female stress urinary incontinence with low urethral closure pressure]. Gynecologie, Obstetrique & Fertilite, 34(9), 692-700.
Sergent F, et al. [Three-year Outcomes of the Tension-free Vaginal Tape Procedure for Treatment of Female Stress Urinary Incontinence With Low Urethral Closure Pressure]. Gynecol Obstet Fertil. 2006;34(9):692-700. PubMed PMID: 16949853.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Three-year outcomes of the tension-free vaginal tape procedure for treatment of female stress urinary incontinence with low urethral closure pressure]. AU - Sergent,F, AU - Popovic,I, AU - Grise,P, AU - Leroi,A-M, AU - Marpeau,L, Y1 - 2006/09/01/ PY - 2005/12/28/received PY - 2006/06/20/accepted PY - 2006/9/5/pubmed PY - 2006/11/11/medline PY - 2006/9/5/entrez SP - 692 EP - 700 JF - Gynecologie, obstetrique & fertilite JO - Gynecol Obstet Fertil VL - 34 IS - 9 N2 - OBJECTIVE: The aim of this study was to assess, with long-term outcome, the effectiveness of TVT for stress urinary incontinence (SUI) with low maximum urethral closure pressure (MUCP) and to identify predicting factors for failure in this case. PATIENTS AND METHODS: This is a bicentric retrospective study including women who underwent a TVT procedure for grade 3-SUI according to the Ingelman-Sundberg's scale. All patients had a low MCUP defined by PCUM < 30 or by the formula 110-the age+/-20% cmH2O. Urethral hypermobility was defined on physical examination and urodynamic investigations. TVT was the only operation performed. Patients were assessed at three months then at longer term with an average follow-up of three years and ever less than one year. RESULTS: A total of 60 women 30 to 78 years old (mean age 55) were so operated. More than third of them (38%) had already been operated for incontinence. Thirty-eight percent had SUI without urethral hypermobility. Thirty percent presented bladder overactivity. The short-term evaluation found that, out of 58 patients, 70,6% cured, 10,3% improved and 18,9% classified as failure. The long-term evaluation, concerning 44 patients, found that 57% remained cured, 16% improved and 27% were classified as failure. Bladder overactivity was cured or improved in more than half of the cases (60%). Ten percent of de novo urgencies were noted, all of which persisted later on. For all that, as much as two thirds of these patients were satisfied with the TVT. Mean age of patients classified as failure, was higher (65 years). Previous SUI surgery did not modify the results. When the MUCP was < 20 cmH2O, success was present only one time out of two. The absence of urethral hypermobility decreased to a significant degree the probability of cure (38 vs. 82,6%, P < 0.01), and more still when bladder overactivity was associated (16,6 vs. 66,6%, P < 0.01). Postoperative voiding troubles constituted a pejorative factor for success of surgery. DISCUSSION AND CONCLUSION: Even if results of TVT with low MCUP are worse, they do not remain less appreciable. When we confront the benefits awaited with this technique compared to the usually described complications, TVT must represent the first treatment of this indication. SN - 1297-9589 UR - https://www.unboundmedicine.com/medline/citation/16949853/[Three_year_outcomes_of_the_tension_free_vaginal_tape_procedure_for_treatment_of_female_stress_urinary_incontinence_with_low_urethral_closure_pressure]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1297-9589(06)00218-9 DB - PRIME DP - Unbound Medicine ER -