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Voiding dysfunction after the tension-free vaginal tape procedure

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Abstract

Throughout the past decade, pubovaginal slings have become the most widely used surgical procedure for the treatment of stress urinary incontinence. However, despite its widespread use and success rates, it is associated with a significant complication rate. In response to the high complication rate, the tension-free vaginal tape (TVT) was introduced. Based on the integral theory that stress urinary incontinence results from defective urethral support, the TVT consists of a loosely placed piece of prolene mesh under the urethra to recreate the pubourethral ligament. However, despite its tension-free nature, studies have shown that the TVT causes postoperative voiding dysfunction in 2.8% to 14% of patients. Radiologic and urodynamic studies suggest that postoperative voiding dysfunction is related to a change in outflow resistance during voiding, not to a change in the bladder neck positioning at rest. Although voiding dysfunction appears to be less after TVT than colposuspensions and the early pubovaginal slings, it does exist and patients should be warned of the potential complication.

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References and Recommended Reading

  1. Kim HL, Gerber GS, Patel RV, et al.: Practice patterns in the treatment of female urinary incontinence: a postal and internet survey. Urology 2001, 57:45–48

    Article  PubMed  CAS  Google Scholar 

  2. Ulmsten U, Petros PP: Female Urology, Urogynecology, and Voiding Dysfunction, edn 1. New York: Marcel Dekker; 2005:950. Comprehensive and detailed overview of the TVT, including historical background, surgical technique, mechanism of action, outcomes, and comparative studies.

    Google Scholar 

  3. Dunn JS Jr, Bent AE, Ellerkman RM, et al.: Voiding dysfunction after surgery for stress incontinence: literature review and survey results. Int Urogynecol J Pelvic Floor Dysfunct 2004, 15:25–31.

    Article  PubMed  Google Scholar 

  4. Kobak WH, Walters MD, Piedmonte MR: Determinants of voiding after three types of incontinence surgery: a multivariable analysis. Obstet Gynecol 2001, 97:86–91.

    Article  PubMed  CAS  Google Scholar 

  5. Hong B, Park S, Kim HS, et al.: Factors predictive of urinary retention after a tension-free vaginal tape procedure for female stress urinary incontinence. J Urol 2003, 170:852–856.

    Article  PubMed  Google Scholar 

  6. Karram MM, Segal JL, Vassallo BJ, et al.: Complications and untoward effects of the tension-free vaginal tape procedure. Obstet Gynecol 2003, 101:929–932.

    Article  PubMed  Google Scholar 

  7. Wang KH, Wang KH, Neimark M, et al.: Voiding dysfunction following TVT procedure. Int Urogynecol J Pelvic Floor Dysfunct 2002, 13:353–357.

    Article  PubMed  CAS  Google Scholar 

  8. Atherton MJ, Stanton SL: The tension-free vaginal tape reviewed: an evidence-based review from inception to current status. BJOG 2005, 112:534–546. Comprehensive review of the TVT literature from 1990 to 2003, discussing its mechanism of action, clinical efficacy, and complications.

    Article  PubMed  Google Scholar 

  9. Deval B, Jeffry L, Al Najjar F, et al.: Determinants of patient dissatisfaction after a tension-free vaginal tape procedure for urinary incontinence. J Urol 2002, 167:2093–2097.

    Article  PubMed  Google Scholar 

  10. Rardin CR, Rosenblatt PL, Kohli N, et al.: Release of tensionfree vaginal tape for the treatment of refractory postoperative voiding dysfunction. Obstet Gynecol 2002, 100:898–902.

    Article  PubMed  CAS  Google Scholar 

  11. Klutke C, Siegel S, Carlin B, et al.: Urinary retention after tension-free vaginal tape procedure: incidence and treatment. Urology 2001, 58:697–701.

    Article  PubMed  CAS  Google Scholar 

  12. Sokol AI, Jelovsek JE, Walters MD, et al.: Incidence and predictors of prolonged urinary retention after TVT with and without concurrent prolapse surgery. Am J Obstet Gynecol 2005, 192:1537–1543. Retrospective review of 267 women to determine the incidence and predictors of voiding dysfunction after TVT. Increasing age, decreasing body mass index, and postoperative urinary tract infection were independent predictors of time to adequate voiding. A history of incontinence surgery was the only independent predictor of urinary retention.

    Article  PubMed  Google Scholar 

  13. Ward K, Hilton P: Prospective, multicenter, randomised trial of tension-free vaginal tape and colposuspension as primary treatment for stress incontinence. BMJ 2002, 325:67. Prospective trial comparing objective and subjective cure rates, postoperative complications, and urodynamic changes of 344 women randomized to TVT or colposuspension.

    Article  PubMed  Google Scholar 

  14. Ward KL, Hilton P: A prospective, multicenter, randomized trial of tension-free vaginal tape and colposuspension for primary urodynamic stress incontinence: 2-year follow-up. Am J Obstet Gynecol 2004, 190:324–331.

    Article  PubMed  Google Scholar 

  15. Wang AC, Chen MC: Comparison of tension-free vaginal taping versus modified Burch colposuspension on urethral obstruction: a randomized, controlled trial. Neurourol Urodyn 2003, 22:185–190. Randomized, controlled trial comparing postoperative voiding dysfunction after Burch colposuspension and TVT with a 12-to 36-month follow-up.

    Article  PubMed  CAS  Google Scholar 

  16. Blaivas JG, Groutz A: Bladder outlet obstruction nomogram for women with lower urinary tract symptomatology. Neurourol Urodyn 2000, 19:553–564.

    Article  PubMed  CAS  Google Scholar 

  17. Liapis A, Bakas P, Creatsas G: Burch colposuspension and tension-free vaginal tape in the management of stress urinary incontinence in women. Eur Urol 2002, 41:469–473.

    Article  PubMed  CAS  Google Scholar 

  18. deTayrac R, Deffieux X, Droupy S, et al.: A prospective, randomized trial comparing tension-free vaginal tape and transobturator suburethral tape for surgical treatment of stress urinary incontinence. Am J Obstet Gynecol 2004, 190:602–608.

    Article  Google Scholar 

  19. Barrington JW, Edwards G, Arunkalaivanan AS, et al.: The use of porcine dermal implant in a minimally invasive pubovaginal sling procedure for genuine stress incontinence. BJU Int 2002, 90:224–227.

    Article  PubMed  CAS  Google Scholar 

  20. Rechberger T, Rzezniczuk K, Skorupski P, et al.: A randomized comparison between monofilament and multifilament tapes for stress incontinence surgery. Int Urogynecol J 2003, 14:432–436.

    Article  Google Scholar 

  21. Sarlos D, Kuronen M, Schaer GN: How does tension-free vaginal tape correct stress incontinence? Investigation by perineal ultrasound. Int Urogynecol J Pelvic Floor Dysfunct 2003, 14:395–398.

    Article  PubMed  Google Scholar 

  22. Virtanen HS, Kiilholma P: Urogynecologic ultrasound is a useful aid in the assessment of female stress urinary incontinence: a prospective study with TVT procedure. Int Urogynecol J Pelvic Floor Dysfunct 2002, 13:218–222.

    Article  PubMed  CAS  Google Scholar 

  23. Dietz HP, Foote AJ, Mak HL, Wilson PD: TVT and SPARC suburethral slings: a case-control series. Int Urogynecol J 2004, 15:129–131.

    Article  CAS  Google Scholar 

  24. Klutke JJ, Carlin BI, Klutke CG: The tension-free vaginal tape procedure: correction of stress incontinence with minimal alteration in proximal urethral mobility. Urology 2000, 55:512–514.

    Article  PubMed  CAS  Google Scholar 

  25. Atherton MJ, Stanton SL: A comparison of bladder neck movement and elevation after tension-free vaginal tape and colposuspension. BJOG 2000, 107:1366–1370.

    Article  PubMed  CAS  Google Scholar 

  26. Lukacz ES, Luber KM, Nager CW: The effects of the tensionfree vaginal tape on voiding function: a prospective evaluation. Int Urogynecol J Pelvic Floor Dysfunct 2004, 15:32–38.

    Article  PubMed  Google Scholar 

  27. Sander P, Moller LM, Rudnicki PM, et al.: Does the tension-free vaginal tape procedure affect the voiding phase? Pressureflow studies before and 1 year after surgery. BJU Int 2002, 89:694–698.

    Article  PubMed  Google Scholar 

  28. Mazouni C, Karsenty G, Bretelle F, et al.: Urinary complications and sexual function after the tension-free vaginal tape procedure. Acta Obstet Gynecol Scand 2004, 83:955–961.

    Article  PubMed  Google Scholar 

  29. Lin LY, Sheu BC, Lin HH: Sequential assessment of urodynamic findings before and after tension-free vaginal tape (TVT) operation for female genuine stress incontinence. Eur Urol 2004, 45:362–366.

    Article  PubMed  Google Scholar 

  30. Mutone N, Brizendine E, Hale D: Factors that influence voiding function after the tension-free vaginal tape procedure for stress urinary incontinence. Am J Obstet Gynecol 2003, 188:1477–1481. Retrospective review of 153 women to determine the risk factors associated with postoperative voiding dysfunction after TVT. Factors assocated with delayed voiding included age, previous anti-incontinence surgery, and previous prolapse surgery.

    Article  PubMed  Google Scholar 

  31. Minassian VA, Al-Badr A, Drutz HP, et al.: Tension-free vaginal tape, Burch, and slings: Are there predictors for early postoperative voiding dysfunction? Int Urogynecol J Pelvic Floor Dysfunct 2004, 15:183–187.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. The Glickman Urological Institute and the Department of Obstetrics and Gynecology, The Cleveland Clinic Foundation, Desk A81, 9500 Euclid Avenue, 44195, Cleveland, OH, USA

    Marie Fidela R. Paraiso MD

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  1. Courtenay Moore MD
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  2. Marie Fidela R. Paraiso MD
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Moore, C., Paraiso, M.F.R. Voiding dysfunction after the tension-free vaginal tape procedure. Curr Urol Rep 6, 356–359 (2005). https://doi.org/10.1007/s11934-005-0052-z

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  • DOI: https://doi.org/10.1007/s11934-005-0052-z

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