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Long-term durability, functional outcomes, and factors associated with surgical failure of tension-free vaginal tape procedure

  • Urology - Original Paper
  • Published:
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Abstract

Purpose

The cure rate of tension-free vaginal tape (TVT) appeared to decrease overtime, with an associated increased in the stress urinary incontinence (SUI) recurrence rate. We evaluated the long-term durability and functional outcomes of TVT and identified the risk factors that may affect recurrence.

Methods

Eighty-eight patients, who were cured of SUI 6 months after undergoing TVT, were followed-up for at least 12 years. At post-operative, the patients were evaluated with a Severity Index for Urinary Incontinence questions regarding cure, patient’s satisfaction, goal achievement, 3-day voiding diary with urinary urgency scale, uroflowmetry, and complications.

Results

Cure rates decreased from 96.6 % at 1-year post-surgery to 83.0 % at 5 years and that the cure rates between 5 and 12 year were similar (83.0 vs. 79.6 %). Valsalva leak point pressure (VLPP) < 60 H2O was the only independent factor that predicted recurrence (p = 0.011; hazard radio 5.31). At last follow-up, 39.2 and 70.0 % of patients were free of urgency and urgency incontinence, respectively; and de novo urgency and urgency incontinence developed in 40.5 and 17.2 % of these patients, respectively. Age was the only factor that predicted freedom from overactive bladder (OAB) symptom. There was a significant reduction in the maximal flow rate from 23.3 ± 9.0 ml/s pre-operation to 18.8 ± 6.7 ml/s at 12 years post-operation.

Conclusions

TVT is an effective long-term treatment for SUI, although the cure rate may decrease with time. A low VLPP was predictive of SUI recurrence, and patients showing no OAB symptoms tended to be younger.

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Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea

    Ji-Yeon Han

  2. Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea

    Junsoo Park & Myung-Soo Choo

Authors
  1. Ji-Yeon Han
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  2. Junsoo Park
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  3. Myung-Soo Choo
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Corresponding author

Correspondence to Myung-Soo Choo.

Appendix

Appendix

See Table 4.

Table 4 Severity Index for Urinary Incontinence in Women
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Han, JY., Park, J. & Choo, MS. Long-term durability, functional outcomes, and factors associated with surgical failure of tension-free vaginal tape procedure. Int Urol Nephrol 46, 1921–1927 (2014). https://doi.org/10.1007/s11255-014-0759-1

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