Long-term Outcomes of Tension-free Vaginal Tape Procedure for Treatment of Female Stress Urinary Incontinence with Intrinsic Sphincter Deficiency

Purpose To assess the long-term outcomes of tension-free vaginal tape (TVT) for stress urinary incontinence (SUI) with intrinsic sphincter deficiency (ISD) and to identify influencing factors for failure in these cases. Methods A total of 136 women who underwent TVT procedures with minimum follow-up...

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Main Authors: Gwoan-Youb Choo, Dae Hyun Kim, Hyoung Keun Park, Sung-Hyun Paick, Yong-Soo Lho, Hyeong-Gon Kim
Format: Article
Language:English
Published: Korean Continence Society 2012-03-01
Series:International Neurourology Journal
Subjects:
Online Access:http://www.einj.org/upload/pdf/inj-16-1-47-8.pdf
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author Gwoan-Youb Choo
Dae Hyun Kim
Hyoung Keun Park
Sung-Hyun Paick
Yong-Soo Lho
Hyeong-Gon Kim
author_facet Gwoan-Youb Choo
Dae Hyun Kim
Hyoung Keun Park
Sung-Hyun Paick
Yong-Soo Lho
Hyeong-Gon Kim
author_sort Gwoan-Youb Choo
collection DOAJ
description Purpose To assess the long-term outcomes of tension-free vaginal tape (TVT) for stress urinary incontinence (SUI) with intrinsic sphincter deficiency (ISD) and to identify influencing factors for failure in these cases. Methods A total of 136 women who underwent TVT procedures with minimum follow-up duration of 3 years were included in the study. Patients were divided into two groups (non-ISD and ISD groups) based on preoperative urodynamic studies. Patient outcomes were assessed from retrospective chart review and telephone research. Cure was defined as the subjective resolution of SUI in any circumstances. Improvement was defined as the subjective improvement of SUI without complete resolution. Failure was defined as the subjective lack of improvement of SUI. Patients in ISD group were subdivided into two subgroups (cure and non-cure groups) and were compared to identify influencing factors for TVT procedure failure. Results Eighty-nine patients were in non-ISD group, and 47 in ISD group. The mean follow-up durations were 50.3±9.2 and 49.7±9.7 months, respectively. Subjective cure rate was 75.3% for non-ISD group, and 76.7% for ISD group (P>0.05). Improvement rate was 6.7% for non-ISD group, and 2.1% for ISD group (P>0.05). Satisfaction scores was 3.8±1.2 points in the non-ISD group, and 3.5±1.2 points in ISD group (P>0.05). In ISD subgroups, VLPP was 41.9±12.0 cmH2O for non-cure group, and 50.5±8.6 cmH2O for cure group, and was the only factor that showed significant statistical difference between the two subgroups (P=0.011). Conclusions With our long-term results, TVT is an effective treatment even in women with ISD. However, ISD patients with low VLPP should be counseled carefully about TVT outcome.
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spelling doaj.art-79c6c5ff14ba4daf853e6daf3659c8652022-12-21T17:34:31ZengKorean Continence SocietyInternational Neurourology Journal2093-47772093-69312012-03-01161475010.5213/inj.2012.16.1.4767Long-term Outcomes of Tension-free Vaginal Tape Procedure for Treatment of Female Stress Urinary Incontinence with Intrinsic Sphincter DeficiencyGwoan-Youb Choo0Dae Hyun Kim1Hyoung Keun Park2Sung-Hyun Paick3Yong-Soo Lho4Hyeong-Gon Kim5Department of Urology, Konkuk University School of Medicine, Seoul, Korea.Department of Urology, Konkuk University School of Medicine, Seoul, Korea.Department of Urology, Konkuk University School of Medicine, Seoul, Korea.Department of Urology, Konkuk University School of Medicine, Seoul, Korea.Department of Urology, Konkuk University School of Medicine, Seoul, Korea.Department of Urology, Konkuk University School of Medicine, Seoul, Korea.Purpose To assess the long-term outcomes of tension-free vaginal tape (TVT) for stress urinary incontinence (SUI) with intrinsic sphincter deficiency (ISD) and to identify influencing factors for failure in these cases. Methods A total of 136 women who underwent TVT procedures with minimum follow-up duration of 3 years were included in the study. Patients were divided into two groups (non-ISD and ISD groups) based on preoperative urodynamic studies. Patient outcomes were assessed from retrospective chart review and telephone research. Cure was defined as the subjective resolution of SUI in any circumstances. Improvement was defined as the subjective improvement of SUI without complete resolution. Failure was defined as the subjective lack of improvement of SUI. Patients in ISD group were subdivided into two subgroups (cure and non-cure groups) and were compared to identify influencing factors for TVT procedure failure. Results Eighty-nine patients were in non-ISD group, and 47 in ISD group. The mean follow-up durations were 50.3±9.2 and 49.7±9.7 months, respectively. Subjective cure rate was 75.3% for non-ISD group, and 76.7% for ISD group (P>0.05). Improvement rate was 6.7% for non-ISD group, and 2.1% for ISD group (P>0.05). Satisfaction scores was 3.8±1.2 points in the non-ISD group, and 3.5±1.2 points in ISD group (P>0.05). In ISD subgroups, VLPP was 41.9±12.0 cmH2O for non-cure group, and 50.5±8.6 cmH2O for cure group, and was the only factor that showed significant statistical difference between the two subgroups (P=0.011). Conclusions With our long-term results, TVT is an effective treatment even in women with ISD. However, ISD patients with low VLPP should be counseled carefully about TVT outcome.http://www.einj.org/upload/pdf/inj-16-1-47-8.pdfStress urinary incontinenceSuburethral slingsUrodynamics
spellingShingle Gwoan-Youb Choo
Dae Hyun Kim
Hyoung Keun Park
Sung-Hyun Paick
Yong-Soo Lho
Hyeong-Gon Kim
Long-term Outcomes of Tension-free Vaginal Tape Procedure for Treatment of Female Stress Urinary Incontinence with Intrinsic Sphincter Deficiency
International Neurourology Journal
Stress urinary incontinence
Suburethral slings
Urodynamics
title Long-term Outcomes of Tension-free Vaginal Tape Procedure for Treatment of Female Stress Urinary Incontinence with Intrinsic Sphincter Deficiency
title_full Long-term Outcomes of Tension-free Vaginal Tape Procedure for Treatment of Female Stress Urinary Incontinence with Intrinsic Sphincter Deficiency
title_fullStr Long-term Outcomes of Tension-free Vaginal Tape Procedure for Treatment of Female Stress Urinary Incontinence with Intrinsic Sphincter Deficiency
title_full_unstemmed Long-term Outcomes of Tension-free Vaginal Tape Procedure for Treatment of Female Stress Urinary Incontinence with Intrinsic Sphincter Deficiency
title_short Long-term Outcomes of Tension-free Vaginal Tape Procedure for Treatment of Female Stress Urinary Incontinence with Intrinsic Sphincter Deficiency
title_sort long term outcomes of tension free vaginal tape procedure for treatment of female stress urinary incontinence with intrinsic sphincter deficiency
topic Stress urinary incontinence
Suburethral slings
Urodynamics
url http://www.einj.org/upload/pdf/inj-16-1-47-8.pdf
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