Surgical complications and medium-term outcome results of tension-free vaginal tape: A prospective study of 313 consecutive patients

• Published in: Neurourology and urodynamics 2004, Vol.23 (1), p.7-9
• Main Authors: Levin, Ishai, Groutz, Asnat, Gold, Ronen, Pauzner, David, Lessing, Joseph B., Gordon, David
• Format: Article
• Language: English
• Subjects: Aged; Device Removal; Female; Follow-Up Studies; Humans; Middle Aged; outcome results; Polypropylenes; Prospective Studies; Prostheses and Implants; Prosthesis Implantation - adverse effects; stress urinary incontinence; surgery; Treatment Outcome; TVT; Urinary Incontinence - etiology; Urinary Incontinence, Stress - physiopathology; Urinary Incontinence, Stress - surgery; Urination Disorders - etiology; Urodynamics; Uterine Prolapse - surgery; Vagina - surgery; Vaginal Diseases - etiology; Vaginal Diseases - surgery
• ISSN: 0733-2467; 1520-6777
• DOI: 10.1002/nau.10164

Objective A prospective study was undertaken to examine the incidence of surgical complications and medium‐term outcomes of tension‐free vaginal tape (TVT) surgery in a large, heterogeneous group of stress‐incontinent women. Methods Surgery was tailored according to preoperative clinical and urodynamic findings: stress‐incontinent women underwent TVT surgery, whereas those with concomitant urogenital prolapse underwent combined TVT and prolapse repair. Post‐operatively the patients were scheduled for evaluation at 1, 3, 6, and 12 months, and annually thereafter. All underwent urodynamics at 3 months post‐operatively. Results Three hundred and thirteen consecutive patients were prospectively studied. The mean follow‐up period was 21.4 ± 13.5 months. Sixteen (5.1%) cases of intravesical passage of the prolene tape occurred in our series, two of which were diagnosed at 3 and 15 months post‐operatively. Eight (2.5%) patients had post‐operative voiding difficulties, necessitating catheterization for more than 7 days. However, transvaginal excision of the tape was required in one case only. Vaginal erosion of the tape was diagnosed in four (1.3%) patients, all of whom were successfully treated by local excision of the eroded tape. Outcome analysis was restricted to 241 consecutive patients with at least 12 months of follow‐up. Subjectively, 16 (6.6%) patients had persistent mild stress urinary incontinence, although urodynamics revealed asymptomatic sphincteric incontinence in 17 (7%) other patients. De‐novo urge incontinence developed post‐operatively in 20 (8.3%) patients. Conclusions The TVT procedure is associated with good medium‐term cure rates, however, it is not free of troublesome complications and the patients should be informed accordingly. Only well‐trained surgeons, familiar with pelvic anatomy, surgical alternatives, and endoscopic techniques should perform the operation. Neurourol. Urodynam. 23:7–9, 2004. © 2003 Wiley‐Liss, Inc.