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Tension-free vaginal tape-obturator in the treatment of stress urinary incontinence: a prospective study with five-year follow-up.
Eur J Obstet Gynecol Reprod Biol. 2012 Apr; 161(2):228-31.EJ

Abstract

OBJECTIVES

To evaluate the medium-term outcomes of using tension-free vaginal tape-obturator (TVT-O) in the treatment of patients with stress urinary incontinence (SUI).

STUDY DESIGN

Between December 2004 and November 2005, 103 patients with SUI were enroled and treated with TVT-O with inside-out modification. A minimum five-year follow-up (median, 65 months) was obtained from 100 patients (99.6%). Preoperative and postoperative evaluations were performed for all patients. The objective success rate of the TVT-O procedure was evaluated by a negative stress test. The secondary outcomes measured included one- and five-year subjective success rates, together with the pre- and post-operative urodynamic parameters, complications, quality of life (QOL) analysis, and patient satisfaction.

RESULTS

Among the 103 patients, 18 (17.4%) had postoperative voiding difficulties and needed urethral bladder catheterization for various periods. After the TVT-O procedure, complete disappearance of SUI occurred in 87.4% of patients, while improvement was found in about 92%. In addition, there was no difference in the cure rate between year 1 and year 5 after the procedure (P>0.05). In 90 patients, frequency and urge symptoms were significantly improved five years after the procedure (P<0.005), and maximal flow rates were decreased (P<0.05). However, the severity of obstructive symptoms and postvoid residual volumes at five years were not improved compared with one year after the procedure (P=0.10 and P=0.33 respectively). Finally, compared to pre-operation, incontinence severity degree and QOL scale scores were largely improved after the operation (P<0.001), while no difference was found between years 1 and 5 (P=0.11and P=0.09 respectively).

CONCLUSIONS

Our result shows that the TVT-obturator, a novel mid-urethral sling, is a safe and effective procedure for the treatment of female SUI. Medium-term therapeutic results appear promising but further evaluation of long-term therapeutic outcomes is needed.

Authors+Show Affiliations

Department of Gynecology and Obstetrics, Shengjing Hospital, China Medical University, Shenyang, China. chengdalishengjing@163.comNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22336228

Citation

Cheng, Dali, and Caigang Liu. "Tension-free Vaginal Tape-obturator in the Treatment of Stress Urinary Incontinence: a Prospective Study With Five-year Follow-up." European Journal of Obstetrics, Gynecology, and Reproductive Biology, vol. 161, no. 2, 2012, pp. 228-31.
Cheng D, Liu C. Tension-free vaginal tape-obturator in the treatment of stress urinary incontinence: a prospective study with five-year follow-up. Eur J Obstet Gynecol Reprod Biol. 2012;161(2):228-31.
Cheng, D., & Liu, C. (2012). Tension-free vaginal tape-obturator in the treatment of stress urinary incontinence: a prospective study with five-year follow-up. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 161(2), 228-31. https://doi.org/10.1016/j.ejogrb.2012.01.011
Cheng D, Liu C. Tension-free Vaginal Tape-obturator in the Treatment of Stress Urinary Incontinence: a Prospective Study With Five-year Follow-up. Eur J Obstet Gynecol Reprod Biol. 2012;161(2):228-31. PubMed PMID: 22336228.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tension-free vaginal tape-obturator in the treatment of stress urinary incontinence: a prospective study with five-year follow-up. AU - Cheng,Dali, AU - Liu,Caigang, Y1 - 2012/02/13/ PY - 2011/08/14/received PY - 2011/12/06/revised PY - 2012/01/09/accepted PY - 2012/2/17/entrez PY - 2012/2/18/pubmed PY - 2012/7/31/medline SP - 228 EP - 31 JF - European journal of obstetrics, gynecology, and reproductive biology JO - Eur J Obstet Gynecol Reprod Biol VL - 161 IS - 2 N2 - OBJECTIVES: To evaluate the medium-term outcomes of using tension-free vaginal tape-obturator (TVT-O) in the treatment of patients with stress urinary incontinence (SUI). STUDY DESIGN: Between December 2004 and November 2005, 103 patients with SUI were enroled and treated with TVT-O with inside-out modification. A minimum five-year follow-up (median, 65 months) was obtained from 100 patients (99.6%). Preoperative and postoperative evaluations were performed for all patients. The objective success rate of the TVT-O procedure was evaluated by a negative stress test. The secondary outcomes measured included one- and five-year subjective success rates, together with the pre- and post-operative urodynamic parameters, complications, quality of life (QOL) analysis, and patient satisfaction. RESULTS: Among the 103 patients, 18 (17.4%) had postoperative voiding difficulties and needed urethral bladder catheterization for various periods. After the TVT-O procedure, complete disappearance of SUI occurred in 87.4% of patients, while improvement was found in about 92%. In addition, there was no difference in the cure rate between year 1 and year 5 after the procedure (P>0.05). In 90 patients, frequency and urge symptoms were significantly improved five years after the procedure (P<0.005), and maximal flow rates were decreased (P<0.05). However, the severity of obstructive symptoms and postvoid residual volumes at five years were not improved compared with one year after the procedure (P=0.10 and P=0.33 respectively). Finally, compared to pre-operation, incontinence severity degree and QOL scale scores were largely improved after the operation (P<0.001), while no difference was found between years 1 and 5 (P=0.11and P=0.09 respectively). CONCLUSIONS: Our result shows that the TVT-obturator, a novel mid-urethral sling, is a safe and effective procedure for the treatment of female SUI. Medium-term therapeutic results appear promising but further evaluation of long-term therapeutic outcomes is needed. SN - 1872-7654 UR - https://www.unboundmedicine.com/medline/citation/22336228/Tension_free_vaginal_tape_obturator_in_the_treatment_of_stress_urinary_incontinence:_a_prospective_study_with_five_year_follow_up_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0301-2115(12)00035-8 DB - PRIME DP - Unbound Medicine ER -