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TVT-O for treatment of pure urodynamic stress urinary incontinence: Efficacy and adverse effects at 13-years follow-up.
Neurourol Urodyn. 2020 06; 39(5):1423-1429.NU

Abstract

AIM

To assess the efficacy and safety of tension-free vaginal tape-obturator (TVT-O) 13 years after implantation for the treatment of female pure stress urinary incontinence (SUI). This is the longest-term evaluation available of TVT-O outcomes.

METHODS

A multicenter, prospective study was conducted in five tertiary referral centers in three countries. All consecutive women with urodynamically proven pure SUI treated by TVT-O were included. Data regarding subjective outcomes (International Consultation on Incontinence Questionnaire-Short Form, Patient Global Impression of Improvement, and patient satisfaction scores), objective cure (stress test) rates, and adverse events were collected during follow-up. Univariable and multivariate analyses was performed to investigate outcomes.

RESULTS

One hundred sixty-eight women had TVT-O implantation. At 13 year after surgery, 150 of 157 patients (95%) declared themselves cured (P = .8). Similarly, at 10-year evaluation, 148 of 160 patients (92%) were objectively cured. No significant deterioration of objective cure rates was observed over time (P = .1). The multivariate analysis showed that previous anti-incontinence procedures and obesity independently predicted the subjective (odd ratio [OR]: 6.2 [95% confidence interval [CI], 1.8-13.6]; P = .02 and OR, 1.8 [95% CI, 1.3-3.0]; P = .03, respectively) and objective failure of TVT-O (OR, 5.8 [95% CI, 1.6-13.2]; P = .02 and OR, 1.6 [95% CI, 1.2-3.2]; P = .03, respectively). We found four cases of sling exposure; all of them occurred after the 10-year follow-up.

CONCLUSIONS

The 13-year results of this study showed that TVT-O is a highly effective and safe option for the treatment of SUI. We found that there is a significantly higher risk of having a sling exposure over 10 years after the procedure; however, the incidence is very low.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Del Ponte Hospital, University of Insubria, Varese, Italy.Department of Obstetrics and Gynecology, EOC-Beata Vergine Hospital, Mendrisio, Switzerland.Department of Obstetrics and Gynecology, EOC-Beata Vergine Hospital, Mendrisio, Switzerland.Department of Obstetrics and Gynecology, Second Faculty, Naples, Italy.Department of Obstetrics and Gynecology, Del Ponte Hospital, University of Insubria, Varese, Italy.Department of Obstetrics and Gynecology Unit, Vita-Salute University and IRCCS San Raffaele Hospital, Milan, Italy.First Department of Obstetrics and Gynecology, "Alexandra" Hospital, University of Athens, Athens, Greece.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

32282099

Citation

Serati, Maurizio, et al. "TVT-O for Treatment of Pure Urodynamic Stress Urinary Incontinence: Efficacy and Adverse Effects at 13-years Follow-up." Neurourology and Urodynamics, vol. 39, no. 5, 2020, pp. 1423-1429.
Serati M, Braga A, Caccia G, et al. TVT-O for treatment of pure urodynamic stress urinary incontinence: Efficacy and adverse effects at 13-years follow-up. Neurourol Urodyn. 2020;39(5):1423-1429.
Serati, M., Braga, A., Caccia, G., Torella, M., Ghezzi, F., Salvatore, S., & Athanasiou, S. (2020). TVT-O for treatment of pure urodynamic stress urinary incontinence: Efficacy and adverse effects at 13-years follow-up. Neurourology and Urodynamics, 39(5), 1423-1429. https://doi.org/10.1002/nau.24358
Serati M, et al. TVT-O for Treatment of Pure Urodynamic Stress Urinary Incontinence: Efficacy and Adverse Effects at 13-years Follow-up. Neurourol Urodyn. 2020;39(5):1423-1429. PubMed PMID: 32282099.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - TVT-O for treatment of pure urodynamic stress urinary incontinence: Efficacy and adverse effects at 13-years follow-up. AU - Serati,Maurizio, AU - Braga,Andrea, AU - Caccia,Giorgio, AU - Torella,Marco, AU - Ghezzi,Fabio, AU - Salvatore,Stefano, AU - Athanasiou,Stavros, Y1 - 2020/04/13/ PY - 2020/01/24/received PY - 2020/03/28/accepted PY - 2020/4/14/pubmed PY - 2020/11/21/medline PY - 2020/4/14/entrez KW - TVT-O KW - long-term follow-up KW - sling KW - stress urinary incontinence KW - tension-free vaginal tape-obturator KW - urinary incontinence SP - 1423 EP - 1429 JF - Neurourology and urodynamics JO - Neurourol Urodyn VL - 39 IS - 5 N2 - AIM: To assess the efficacy and safety of tension-free vaginal tape-obturator (TVT-O) 13 years after implantation for the treatment of female pure stress urinary incontinence (SUI). This is the longest-term evaluation available of TVT-O outcomes. METHODS: A multicenter, prospective study was conducted in five tertiary referral centers in three countries. All consecutive women with urodynamically proven pure SUI treated by TVT-O were included. Data regarding subjective outcomes (International Consultation on Incontinence Questionnaire-Short Form, Patient Global Impression of Improvement, and patient satisfaction scores), objective cure (stress test) rates, and adverse events were collected during follow-up. Univariable and multivariate analyses was performed to investigate outcomes. RESULTS: One hundred sixty-eight women had TVT-O implantation. At 13 year after surgery, 150 of 157 patients (95%) declared themselves cured (P = .8). Similarly, at 10-year evaluation, 148 of 160 patients (92%) were objectively cured. No significant deterioration of objective cure rates was observed over time (P = .1). The multivariate analysis showed that previous anti-incontinence procedures and obesity independently predicted the subjective (odd ratio [OR]: 6.2 [95% confidence interval [CI], 1.8-13.6]; P = .02 and OR, 1.8 [95% CI, 1.3-3.0]; P = .03, respectively) and objective failure of TVT-O (OR, 5.8 [95% CI, 1.6-13.2]; P = .02 and OR, 1.6 [95% CI, 1.2-3.2]; P = .03, respectively). We found four cases of sling exposure; all of them occurred after the 10-year follow-up. CONCLUSIONS: The 13-year results of this study showed that TVT-O is a highly effective and safe option for the treatment of SUI. We found that there is a significantly higher risk of having a sling exposure over 10 years after the procedure; however, the incidence is very low. SN - 1520-6777 UR - https://www.unboundmedicine.com/medline/citation/32282099/TVT_O_for_treatment_of_pure_urodynamic_stress_urinary_incontinence:_Efficacy_and_adverse_effects_at_13_years_follow_up_ L2 - https://doi.org/10.1002/nau.24358 DB - PRIME DP - Unbound Medicine ER -