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Long-term follow-up of the retropubic tension-free vaginal tape procedure

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Abstract

Introduction and hypothesis

Retropubic tension-free vaginal tape (TVT) was introduced in 1996 as a new and innovative surgical approach in the treatment of stress urinary incontinence (SUI). In this study we evaluate the long-term objective and subjective outcomes in a non-selected patient population 10 years after the retropubic TVT procedure.

Methods

All women (603) operated on with retropubic TVT at four gynecological departments from September 1998 through December 2000 were identified, and those still alive (542) were invited to participate in this population-based prospective study. For subjective data a short-form urinary incontinence disease-specific questionnaire was used. For objective evaluation the women underwent a stress test. Data collected were merged with previously stored data in the Norwegian National Incontinence Registry Database.

Results

We included 483 women; 327 attended a clinical follow-up consultation and 156 had a telephone interview. Median duration of follow-up was 129 months. Objective cure rate was 89.9 %, subjective cure rate was 76.1 %, and 82.6 % of the patients stated they were “very satisfied” with their surgery (treatment satisfaction rate). Only 2.3 % of the women had undergone repeat SUI surgery. Subjective voiding difficulties were reported by 22.8 %, the majority describing slow stream or intermittency. De novo urgency incontinence increased significantly from 4.1 % 6–12 months after surgery to 14.9 % at the 10-year follow-up.

Conclusions

Long-term objective and subjective outcome after retropubic TVT is excellent with a low number of re-operations even in a non-selected cohort of patients.

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Acknowledgements

Valuable help in collecting data and evaluating women at this 10-year follow-up was given by: Berit Ellefsen, urotherapist, Østfold Hospital (compensated by Østfold Hospital); Unni Sørensen, urotherapist, Asker and Bærum Hospital (compensated by Asker and Bærum Hospital); Anne Torine Litherland and Mette Elisabeth Pedersen, urotherapists, Vestfold Hospital (compensated by Vestfold Hospital); Øystein Bjørnerud, uro-assistant, Oslo University Hospital (compensated by Oslo University Hospital). Data assistance from the National Incontinence Registry provided by: Tomislav Dimovski, system developer (compensated by the National Incontinence Registry and grants from the Nordic Urogynaecologic Association [NUGA] and the Norwegian Urodynamic Discussion Group [UDYDIG]). Statistical support was provided by: Leiv Sandvik, Professor, Unit of Biostatistics and Epidemiology, Oslo University Hospital and Faculty of Medicine Oslo University (compensated by Oslo University Hospital).

Funding

The study was financed by the respective institutions and by grants from the Nordic Urogynaecologic Association (NUGA) and the Norwegian Urodynamic Discussion Group (UDYDIG).

Conflicts of interest

Rune Svenningsen: speaker fee from Astellas; travel grants from Pfizer, Astellas, Johnson & Johnson and Boston Scientific. Anne C. Staff: speaker fee from Roche. Hjalmar Schiøtz: speaker fees, travel grants, advisory board fees, and remuneration for clinical drug studies from Astellas, Contura, Eli Lilly, Johnson&Johnson/Gynecare, MSD Sanofi Pasteur, Pfizer, and Upviser. Kari Western: Norwegian advisory board Astellas. Sigurd Kulseng-Hanssen: Nordic advisory board Allergan; travel grants from Pfizer and Gynecare.

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Authors and Affiliations

  1. Department of Gynaecology, Oslo University Hospital, POB 4956, 0424, Nydalen, Oslo, Norway

    Rune Svenningsen & Anne C. Staff

  2. Faculty of Medicine, University of Oslo, Oslo, Norway

    Anne C. Staff

  3. Department of Obstetrics and Gynaecology, Vestfold Hospital, Tønsberg, Norway

    Hjalmar A. Schiøtz

  4. Department of Obstetrics and Gynaecology, Østfold Hospital, Fredrikstad, Norway

    Kari Western

  5. Department of Obstetrics and Gynaecology, Asker and Bærum Hospital, Bærum, Norway

    Sigurd Kulseng-Hanssen

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  1. Rune Svenningsen
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  2. Anne C. Staff
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  3. Hjalmar A. Schiøtz
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  4. Kari Western
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  5. Sigurd Kulseng-Hanssen
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Correspondence to Rune Svenningsen.

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Svenningsen, R., Staff, A.C., Schiøtz, H.A. et al. Long-term follow-up of the retropubic tension-free vaginal tape procedure. Int Urogynecol J 24, 1271–1278 (2013). https://doi.org/10.1007/s00192-013-2058-2

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  • DOI: https://doi.org/10.1007/s00192-013-2058-2

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