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Seven years of objective and subjective outcomes of transobturator (TVT-O) vaginal tape: why do tapes fail?
Int Urogynecol J. 2014 Feb; 25(2):219-25.IU

Abstract

INTRODUCTION AND HYPOTHESIS

This study reports long-term outcomes of the transvaginal tension-free vaginal tape-obturator (TVT-O) procedure for treating stress urinary incontinence (SUI), including possible risk factors for failure.

METHODS

This was a retrospective study of women who underwent TVT-O with or without concomitant prolapse surgery. Procedures were performed at a tertiary referral urogynecology unit. Participants presented with SUI and had urodynamic stress incontinence (USI). Women with a history of previous anti-incontinence procedures, radical pelvic surgery, and detrusor overactivity (DO) were excluded. Objective cure was defined as absence of urine leakage during a cough stress test (CST). Subjective outcome was based on the International Consultation on Incontinence Questionnaire for Evaluating Female Lower Urinary Tract Symptoms (ICIQ-FLUTS). Quality of life was assessed using the King's Health Questionnaire (KHQ). Univariate and multivariate analyses were used to identify risk factors for subjective failure.

RESULTS

One hundred twenty-four consecutive women were assessed, with a median follow-up of 90.3 (range 80-103) months. Overall objective and subjective cure rates were 81.5 % (101/124) and 83.5 % (103/124), respectively. A significant improvement was observed in all KHQ domains. Concomitant vaginal hysterectomy [odds ratio (OR) = 2.98, 95 % confidence interval (CI) 1.10-8.05, p = 0.03] and increasing point C (OR = 1.17, 95 % CI 1.05-1.30, p = 0.006] were associated with a higher risk for subjective failure. De novo urgency rate was 7 %.

CONCLUSIONS

The TVT-O procedure provides high objective and subjective long-term efficacy, a clinically meaningful improvement in patient quality of life, and an excellent safety profile. Concomitant vaginal hysterectomy and apical compartment prolapse were associated with a higher risk for objective and subjective failure.

Authors+Show Affiliations

First Department of Obstetrics and Gynecology, Urogynecology Unit, National & Kapodistrian University of Athens, "Alexandra" Hospital, 80 Vas. Sofias Avenue, 11528, Athens, Greece, stavros.athanasiou@gmail.com.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

23892532

Citation

Athanasiou, Stavros, et al. "Seven Years of Objective and Subjective Outcomes of Transobturator (TVT-O) Vaginal Tape: Why Do Tapes Fail?" International Urogynecology Journal, vol. 25, no. 2, 2014, pp. 219-25.
Athanasiou S, Grigoriadis T, Zacharakis D, et al. Seven years of objective and subjective outcomes of transobturator (TVT-O) vaginal tape: why do tapes fail? Int Urogynecol J. 2014;25(2):219-25.
Athanasiou, S., Grigoriadis, T., Zacharakis, D., Skampardonis, N., Lourantou, D., & Antsaklis, A. (2014). Seven years of objective and subjective outcomes of transobturator (TVT-O) vaginal tape: why do tapes fail? International Urogynecology Journal, 25(2), 219-25. https://doi.org/10.1007/s00192-013-2186-8
Athanasiou S, et al. Seven Years of Objective and Subjective Outcomes of Transobturator (TVT-O) Vaginal Tape: Why Do Tapes Fail. Int Urogynecol J. 2014;25(2):219-25. PubMed PMID: 23892532.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Seven years of objective and subjective outcomes of transobturator (TVT-O) vaginal tape: why do tapes fail? AU - Athanasiou,Stavros, AU - Grigoriadis,Themos, AU - Zacharakis,Dimitrios, AU - Skampardonis,Nikolaos, AU - Lourantou,Dionysia, AU - Antsaklis,Aris, Y1 - 2013/07/27/ PY - 2013/05/07/received PY - 2013/07/03/accepted PY - 2013/7/30/entrez PY - 2013/7/31/pubmed PY - 2014/10/1/medline SP - 219 EP - 25 JF - International urogynecology journal JO - Int Urogynecol J VL - 25 IS - 2 N2 - INTRODUCTION AND HYPOTHESIS: This study reports long-term outcomes of the transvaginal tension-free vaginal tape-obturator (TVT-O) procedure for treating stress urinary incontinence (SUI), including possible risk factors for failure. METHODS: This was a retrospective study of women who underwent TVT-O with or without concomitant prolapse surgery. Procedures were performed at a tertiary referral urogynecology unit. Participants presented with SUI and had urodynamic stress incontinence (USI). Women with a history of previous anti-incontinence procedures, radical pelvic surgery, and detrusor overactivity (DO) were excluded. Objective cure was defined as absence of urine leakage during a cough stress test (CST). Subjective outcome was based on the International Consultation on Incontinence Questionnaire for Evaluating Female Lower Urinary Tract Symptoms (ICIQ-FLUTS). Quality of life was assessed using the King's Health Questionnaire (KHQ). Univariate and multivariate analyses were used to identify risk factors for subjective failure. RESULTS: One hundred twenty-four consecutive women were assessed, with a median follow-up of 90.3 (range 80-103) months. Overall objective and subjective cure rates were 81.5 % (101/124) and 83.5 % (103/124), respectively. A significant improvement was observed in all KHQ domains. Concomitant vaginal hysterectomy [odds ratio (OR) = 2.98, 95 % confidence interval (CI) 1.10-8.05, p = 0.03] and increasing point C (OR = 1.17, 95 % CI 1.05-1.30, p = 0.006] were associated with a higher risk for subjective failure. De novo urgency rate was 7 %. CONCLUSIONS: The TVT-O procedure provides high objective and subjective long-term efficacy, a clinically meaningful improvement in patient quality of life, and an excellent safety profile. Concomitant vaginal hysterectomy and apical compartment prolapse were associated with a higher risk for objective and subjective failure. SN - 1433-3023 UR - https://www.unboundmedicine.com/medline/citation/23892532/Seven_years_of_objective_and_subjective_outcomes_of_transobturator__TVT_O__vaginal_tape:_why_do_tapes_fail L2 - https://dx.doi.org/10.1007/s00192-013-2186-8 DB - PRIME DP - Unbound Medicine ER -