Skip to main content

Advertisement

SpringerLink
Log in

A 10- to 20-year follow-up after tension-free vaginal tape for stress urinary incontinence

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

Midurethral slings (MUS) have become the gold standard in the treatment of stress urinary incontinence (SUI). Some information is already available on the outcome of tension-free vaginal tape (TVT) after 10 years or more. Our objective was to assess the current outcome (efficacy, adverse events) of women who had been successfully operated upon for SUI by means of a TVT procedure 10 to 20 years ago.

Methods

We performed a retrospective cohort study including 291 women (mean age 69.4 years) who underwent a successful TVT procedure (retropubic bottom-to-top route) in a teaching hospital between January 2001 and December 2010. The main outcome measure was the incidence of SUI at 10–20 years’ follow-up. Others were incidence of re-operation, tape exposure and de novo overactive bladder symptoms. We carried out a univariate logistic regression analysis to examine the relationship between outcomes and a set of clinical variables.

Results

After a median of 15 years, TVT remains highly effective: 272 women (94%) experienced either no leakage under any circumstance (214=74%) or leakage less than weekly (58=20%). Mesh exposure (8=2.7%; 1.8 events per 1,000 patient-years) and repeat surgery for SUI (11=3.8%; 2.5 events per 1,000 patient-years) were low. Three women (1%) needed to perform intermittent self-catheterisation. Bothersome overactive bladder symptoms (45=15%) were common and associated with polypharmacy, cardiovascular medication and obesity.

Conclusion

The efficacy of TVT is demonstrated up to 20 years. The presence of bothersome OAB symptoms in the population may be an indicator of multimorbidity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Rogers RG. Clinical practice. Urinary stress incontinence in women. N Engl J Med. 2008;358:1029–36. https://doi.org/10.1056/NEJMcp0707023.

    Article  CAS  PubMed  Google Scholar 

  2. Cammu H, Van Nylen M, Blockeel C, Kaufman L, Amy JJ. Who will benefit from pelvic floor muscle training for stress urinary incontinence? Am J Obstet Gynecol. 2004;191:1152–7. https://doi.org/10.1016/j.ajog.2004.05.012.

    Article  PubMed  Google Scholar 

  3. Ulmsten U, Petros P. Intravaginal slingplasty (IVS): an ambulatory surgical procedure for treatment of female urinary incontinence. Scand J Urol Nephrol. 1995;29:75–82. https://doi.org/10.3109/00365599509180543.

    Article  CAS  PubMed  Google Scholar 

  4. Nilsson CG. Creating a gold standard surgical procedure: the development and implementation of TVT. Int Urogynecol J. 2015;26:467–9. https://doi.org/10.1007/s00192-014-2616-2.

    Article  PubMed  Google Scholar 

  5. Imamura M, Hudson J, Wallace SA, et al. Surgical interventions for women with stress urinary incontinence: systematic review and network meta-analysis of randomised controlled trials. BMJ. 2019;365:1842. https://doi.org/10.1136/bmj.l1842.

    Article  Google Scholar 

  6. Dwyer PL. Nothing lasts forever? Long-term outcomes of stress urinary incontinence surgery. Int Urogynecol J. 2013;24:1241–2. https://doi.org/10.1007/s00192-013-2114-y.

    Article  PubMed  Google Scholar 

  7. Cammu H, Van Den Abbeele E, Nagel H, Haentjens P. Factors predictive of outcome in tension-free vaginal tape procedure for urinary stress incontinence in a teaching hospital. Int Urogynecol J. 2009;20:775–80. https://doi.org/10.1007/s00192-009-0851-8.

    Article  Google Scholar 

  8. Groutz A, Rosen G, Cohen A, Gold R, Lessing JB, Gordon D. Ten-year subjective outcome results of the retropubic tension-free vaginal tape for treatment of stress urinary incontinence. J Minim Invasive Gynecol. 2011;18:726–9. https://doi.org/10.1016/j.jmig.2011.07.006.

    Article  PubMed  Google Scholar 

  9. Aigmueller T, Trutnovsky G, Tamussino K, et al. Ten-year follow-up after the tension-free vaginal tape procedure. Am J Obstet Gynecol. 2011;205:496.e1–5. https://doi.org/10.1016/j.ajog.2011.07.010.

    Article  PubMed  Google Scholar 

  10. Heinonen P, Ala-Nissilä S, Kiiholma P, Laurikainen E. Tension-free vaginal tape procedure without preoperative urodynamic examination: long-term outcome. Int J Urol. 2012;19:1003–9. https://doi.org/10.1111/j.1442-2042.2012.03078.x.

    Article  PubMed  Google Scholar 

  11. Svenningsen R, Staff AC, Schiøtz HA, Western K, Kulseng-Hanssen S. Long-term follow-up of the retropubic tension-free vaginal tape procedure. Int Urogynecol J. 2013;24:1271–8. https://doi.org/10.1007/s00192-013-2058-2.

    Article  PubMed  Google Scholar 

  12. Nilsson CG, Palva K, Aarnio R, Morcos E, Falconer C. Seventeen years' follow-up of the tension-free vaginal tape procedure for female stress urinary incontinence. Int Urogynecol J. 2013;24:1265–9. https://doi.org/10.1007/s00192-013-2090-2.

    Article  CAS  PubMed  Google Scholar 

  13. Serati M, Sorice P, Bogani G, et al. TVT for the treatment of urodynamic stress incontinence: efficacy and adverse effects at 13-year follow-up. Neurourol Urodyn. 2015;36:192–7. https://doi.org/10.1002/nau.22914.

    Article  PubMed  Google Scholar 

  14. Song PH, Kwon DH, Ko YH, Jung HC. The long-term outcomes of the tension-free vaginal tape procedure for treatment of female stress urinary incontinence: data from minimum 13 years of follow-up. Low Urin Tract Symptoms. 2017;9:10–4. https://doi.org/10.1111/luts.12099.

    Article  PubMed  Google Scholar 

  15. Braga A, Caccia G, Sorice P, et al. Tension-free vaginal tape for treatment of pure urodynamic stress urinary incontinence: efficacy and adverse effects at 17-year follow-up. BJU Int. 2018;122:113–7. https://doi.org/10.1111/bju.14136.

    Article  PubMed  Google Scholar 

  16. Bakas P, Papadakis E, Karachalios C, Liapis I, Panagopoulos N, Liapis A. Assessment of the long-term outcome of TVT procedure for stress urinary incontinence in a female population: results at 17 years’ follow-up. Int Urogynecol J. 2019;30:265–9. https://doi.org/10.1007/s00192-018-3713-4.

    Article  PubMed  Google Scholar 

  17. Zhang Y, Song X, Mao M, Kang J, Ai F, Zhu L. Tension-free vaginal tape for the treatment of stress urinary incontinence: a 13-year prospective follow-up. J Minim Invasive Gynecol. 2019;26:754–9. https://doi.org/10.1016/j.jmig.2018.08.010.

    Article  CAS  PubMed  Google Scholar 

  18. Karmakar D, Dwyer PL, Murray C, Schierlitz L, Dykes N, Zilberlicht A. Long-term effectiveness and safety of open Burch colposuspension versus retropubic midurethral sling for stress urinary incontinence—results from a large comparative study. Am J Obstet Gynecol. 2021;224:593.e1–8. https://doi.org/10.1016/j.ajog.2020.11.043.

    Article  PubMed  Google Scholar 

  19. Braga A, Caccia G, Papadia A, et al. The subjective and objective very long-term outcomes of TVT in the COVID era: a 20-year follow-up. Int Urogynecol J. 2022;33(4):947–53. https://doi.org/10.1007/s00192-022-05094-9.

    Article  PubMed  PubMed Central  Google Scholar 

  20. O’Leary BD, McCreery A, Redmond A, Keane DP. The efficacy and complications of retropubic tension-free vaginal tapes after 20 years: a prospective observational study. BJOG. 2022;130:107–113. https://doi.org/10.1111/1471-0528.17282.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Wu JM. Stress incontinence in women. N Engl J Med. 2021;384:2428–36. https://doi.org/10.1056/NEJMcp1914037.

    Article  PubMed  Google Scholar 

  22. Jolleys JV. Reported prevalence of urinary incontinence in women in a general practice. Br Med J. 1988;296:1300–2. https://doi.org/10.1136/bmj.296.6632.1300.

    Article  CAS  Google Scholar 

  23. Berger AA, Tan-Kim J, Menefee SA. Long-term risk of reoperation after synthetic mesh midurethral sling surgery for stress urinary incontinence. Obstet Gynecol. 2019;134:1047–55. https://doi.org/10.1097/AOG.0000000000003526.

    Article  PubMed  Google Scholar 

  24. Gurol-Urganci I, Geary RS, Mamza JB, et al. Long-term rate of mesh sling removal following midurethral mesh sling Insertion among women with stress urinary incontinence. JAMA. 2018;320:1659–69. https://doi.org/10.1001/jama.2018.14997.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Tulokas S, Rahkola-Soisalo P, Gissler M, et al. Long-term re-procedure rate after mid-urethral slings for stress urinary incontinence. Int Urogynecol J. 2020;31(4):727–35. https://doi.org/10.1007/s00192-019-04223-1.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Dejene SZ, Jonsson Funk M, Pate V, Wu JM. Long-term outcomes after midurethral mesh sling surgery for stress urinary incontinence. Female Pelvic Med Reconstr Surg. 2022;28(4):188–93. https://doi.org/10.1097/SPV.0000000000001094.

    Article  PubMed  Google Scholar 

  27. Gibson W, Wagg A. Incontinence in the elderly, ‘normal’ ageing, or unaddressed pathology? Nat Rev Urol. 2017;14:440–8. https://doi.org/10.1038/nrurol.2017.53.

    Article  PubMed  Google Scholar 

  28. Aigmueller A, Bjelic-Radisic V, Kargl J, et al. Reasons for dissatisfaction ten years after TVT procedure. Int Urogynecol J. 2014;25:213–7. https://doi.org/10.1007/s00192-013-2213-9.

    Article  PubMed  Google Scholar 

  29. Abrams P, Andersson KE, Apostolidis A, et al. 6th International Consultation on Incontinence. Recommendations of the International Scientific Committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse and faecal incontinence. Neurourol Urodyn. 2018;37(7):2271–2. https://doi.org/10.1002/nau.23551.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank Roos Colman and Jako for the statistical analysis.

Author information

Authors and Affiliations

  1. Department of Urology, ZNA Middelheim Antwerpen, Lindendreef 1, 2020, Antwerp, Belgium

    Emilie M. V. Goessens

  2. Department of Gynaecology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium

    Hendrik Cammu

Authors
  1. Emilie M. V. Goessens
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hendrik Cammu
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

E. Goessens: data collection and management, manuscript writing; H. Cammu: project development, data analysis, manuscript editing.

Corresponding author

Correspondence to Emilie M. V. Goessens.

Ethics declarations

Conflicts of interest

None.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Goessens, E.M.V., Cammu, H. A 10- to 20-year follow-up after tension-free vaginal tape for stress urinary incontinence. Int Urogynecol J 34, 2107–2114 (2023). https://doi.org/10.1007/s00192-023-05510-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-023-05510-8

Keywords

Search

Navigation