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TVT-O for the treatment of pure urodynamic stress incontinence: efficacy, adverse effects, and prognostic factors at 5-year follow-up.
Eur Urol. 2013 May; 63(5):872-8.EU

Abstract

BACKGROUND

Inside-out tension-free vaginal transobturator tape (TVT-O) is currently one of the most effective and popular procedures for the surgical treatment of female stress urinary incontinence (SUI), but data reporting long-term outcomes are scarce.

OBJECTIVE

To evaluate the efficacy and safety of TVT-O 5-yr implantation for management of pure SUI in women.

DESIGN, SETTING, AND PARTICIPANTS

A prospective observational study was conducted in four tertiary reference centers. Consecutive women presenting with urodynamically proven, pure SUI treated by TVT-O were included. Patients with mixed incontinence and/or anatomic evidence of pelvic organ prolapse were excluded.

INTERVENTION

TVT-O implantation without any associated procedure.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS

Data regarding subjective outcomes (International Consultation on Incontinence-Short Form [ICIQ-SF], Patient Global Impression of Improvement, patient satisfaction scores), objective cure (stress test) rates, and adverse events were collected during follow-up. Multivariable analyses were performed to investigate outcomes.

RESULTS AND LIMITATIONS

Of the 191 women included, 21 (11.0%) had previously undergone a failed anti-incontinence surgical procedure. Six (3.1%) patients were lost to follow-up. The 5-yr subjective and objective cure rates were 90.3% and 90.8%, respectively. De novo overactive bladder (OAB) was reported by 24.3% of patients at 5-yr follow-up. Median ICIQ-SF score significantly improved from 17 (interquartile range [IQR]:16-17) preoperatively to 0 (IQR: 0-2) (p<0.0001). Failure of a previous anti-incontinence procedure was the only independent predictor of subjective recurrence of SUI (hazard ratio [HR]: 4.4; p = 0.009) or objective (HR: 3.7; p = 0.02). No predictive factor of de novo OAB was identified.

CONCLUSIONS

TVT-O implantation is a highly effective option for the treatment of women with pure SUI, showing a very high cure rate and a low incidence of complications after 5-yr follow-up.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy. mauserati@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

23274106

Citation

Serati, Maurizio, et al. "TVT-O for the Treatment of Pure Urodynamic Stress Incontinence: Efficacy, Adverse Effects, and Prognostic Factors at 5-year Follow-up." European Urology, vol. 63, no. 5, 2013, pp. 872-8.
Serati M, Bauer R, Cornu JN, et al. TVT-O for the treatment of pure urodynamic stress incontinence: efficacy, adverse effects, and prognostic factors at 5-year follow-up. Eur Urol. 2013;63(5):872-8.
Serati, M., Bauer, R., Cornu, J. N., Cattoni, E., Braga, A., Siesto, G., Lizée, D., Haab, F., Torella, M., & Salvatore, S. (2013). TVT-O for the treatment of pure urodynamic stress incontinence: efficacy, adverse effects, and prognostic factors at 5-year follow-up. European Urology, 63(5), 872-8. https://doi.org/10.1016/j.eururo.2012.12.022
Serati M, et al. TVT-O for the Treatment of Pure Urodynamic Stress Incontinence: Efficacy, Adverse Effects, and Prognostic Factors at 5-year Follow-up. Eur Urol. 2013;63(5):872-8. PubMed PMID: 23274106.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - TVT-O for the treatment of pure urodynamic stress incontinence: efficacy, adverse effects, and prognostic factors at 5-year follow-up. AU - Serati,Maurizio, AU - Bauer,Ricarda, AU - Cornu,Jean Nicolas, AU - Cattoni,Elena, AU - Braga,Andrea, AU - Siesto,Gabriele, AU - Lizée,Daphné, AU - Haab,François, AU - Torella,Marco, AU - Salvatore,Stefano, Y1 - 2012/12/20/ PY - 2012/11/01/received PY - 2012/12/10/accepted PY - 2013/1/1/entrez PY - 2013/1/1/pubmed PY - 2013/9/26/medline SP - 872 EP - 8 JF - European urology JO - Eur Urol VL - 63 IS - 5 N2 - BACKGROUND: Inside-out tension-free vaginal transobturator tape (TVT-O) is currently one of the most effective and popular procedures for the surgical treatment of female stress urinary incontinence (SUI), but data reporting long-term outcomes are scarce. OBJECTIVE: To evaluate the efficacy and safety of TVT-O 5-yr implantation for management of pure SUI in women. DESIGN, SETTING, AND PARTICIPANTS: A prospective observational study was conducted in four tertiary reference centers. Consecutive women presenting with urodynamically proven, pure SUI treated by TVT-O were included. Patients with mixed incontinence and/or anatomic evidence of pelvic organ prolapse were excluded. INTERVENTION: TVT-O implantation without any associated procedure. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Data regarding subjective outcomes (International Consultation on Incontinence-Short Form [ICIQ-SF], Patient Global Impression of Improvement, patient satisfaction scores), objective cure (stress test) rates, and adverse events were collected during follow-up. Multivariable analyses were performed to investigate outcomes. RESULTS AND LIMITATIONS: Of the 191 women included, 21 (11.0%) had previously undergone a failed anti-incontinence surgical procedure. Six (3.1%) patients were lost to follow-up. The 5-yr subjective and objective cure rates were 90.3% and 90.8%, respectively. De novo overactive bladder (OAB) was reported by 24.3% of patients at 5-yr follow-up. Median ICIQ-SF score significantly improved from 17 (interquartile range [IQR]:16-17) preoperatively to 0 (IQR: 0-2) (p<0.0001). Failure of a previous anti-incontinence procedure was the only independent predictor of subjective recurrence of SUI (hazard ratio [HR]: 4.4; p = 0.009) or objective (HR: 3.7; p = 0.02). No predictive factor of de novo OAB was identified. CONCLUSIONS: TVT-O implantation is a highly effective option for the treatment of women with pure SUI, showing a very high cure rate and a low incidence of complications after 5-yr follow-up. SN - 1873-7560 UR - https://www.unboundmedicine.com/medline/citation/23274106/TVT_O_for_the_treatment_of_pure_urodynamic_stress_incontinence:_efficacy_adverse_effects_and_prognostic_factors_at_5_year_follow_up_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0302-2838(12)01491-1 DB - PRIME DP - Unbound Medicine ER -