The Long Term (5-Years) Objective TVT Success Rate Does Not Depend on Predictive Factors at Multivariate Analysis

• Published in: European urology 2008-01, Vol.53 (1), p.176-183
• Main Authors: Lee, Kyu-Sung, Choo, Myung-Soo, Doo, Chin Kyung, Han, Deok-Hyun, Lee, Young-Suk, Kim, Ji Yoon, Kim, Wan Suk, Jung, Hee Chang
• Format: Article
• Language: English
• Subjects: Precipitating factors; Stress urinary incontinence; Surgery; Urology
• ISSN: 0302-2838; 1873-7560
• DOI: 10.1016/j.eururo.2007.08.033

Abstract Objectives We evaluated the predictive risk factors that could affect the long-term efficacy of the tension-free vaginal tape (TVT) procedure for the treatment of female stress urinary incontinence (SUI). Methods One hundred thirty-eight (mean age, 52.4 ± 9.3 yr) women who underwent the TVT procedure for SUI were selected and followed up for at least 5 yr (mean, 67.2 mo; range, 60–76) after the surgery. We analyzed the preoperative and intraoperative parameters using univariate and multivariate regression for cure rates and patients’ satisfaction. Results The overall 5-yr cure rate was 76.8%, with a satisfaction rate of 86.9%. The cure rates were lower in patients with high body mass index (BMI ≥ 25 kg/m2 /BMI < 25 kg/m2 = 68.3%:83.3%, p = 0.044), low abdominal leak point pressure (ALPP < 60 cm H2 O/ALPP ≥ 60 cm H2 O = 51.6%:82.8%, p = 0.003), and high grade of SUI (40.0% in grade III; 69.7% in grade II; 86.6% in grade I, p = 0.012). On multivariate analysis, there were no independent risk factors related to cure rate, and urgency was the only factor independently associated with patients’ satisfaction ( p = 0.017; odds ratio = 4.114). Conclusions This study demonstrates that the TVT procedure is effective for female SUI without any independent predictive factors affecting long-term cure rate. Urgency was the only predictive factor affecting patient satisfaction. However, high BMI, low ALPP, and high grade of incontinence may impair the cure rate of the TVT.