| TVT-O for the Treatment of Pure Urodynamic Stress Incontinence: Efficacy, Adverse Effects, and Prognostic Factors at 5-Year Follow-up. | |
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MedLine Citation:
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PMID: 23274106 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Inside-out tension-free vaginal transobturator tape (TVT-O) is currently one of the most effective and popular procedures for the surgical treatment of female stress urinary incontinence (SUI), but data reporting long-term outcomes are scarce. OBJECTIVE: To evaluate the efficacy and safety of TVT-O 5-yr implantation for management of pure SUI in women. DESIGN, SETTING, AND PARTICIPANTS: A prospective observational study was conducted in four tertiary reference centers. Consecutive women presenting with urodynamically proven, pure SUI treated by TVT-O were included. Patients with mixed incontinence and/or anatomic evidence of pelvic organ prolapse were excluded. INTERVENTION: TVT-O implantation without any associated procedure. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Data regarding subjective outcomes (International Consultation on Incontinence-Short Form [ICIQ-SF], Patient Global Impression of Improvement, patient satisfaction scores), objective cure (stress test) rates, and adverse events were collected during follow-up. Multivariable analyses were performed to investigate outcomes. RESULTS AND LIMITATIONS: Of the 191 women included, 21 (11.0%) had previously undergone a failed anti-incontinence surgical procedure. Six (3.1%) patients were lost to follow-up. The 5-yr subjective and objective cure rates were 90.3% and 90.8%, respectively. De novo overactive bladder (OAB) was reported by 24.3% of patients at 5-yr follow-up. Median ICIQ-SF score significantly improved from 17 (interquartile range [IQR]:16-17) preoperatively to 0 (IQR: 0-2) (p<0.0001). Failure of a previous anti-incontinence procedure was the only independent predictor of subjective recurrence of SUI (hazard ratio [HR]: 4.4; p=0.009) or objective (HR: 3.7; p=0.02). No predictive factor of de novo OAB was identified. CONCLUSIONS: TVT-O implantation is a highly effective option for the treatment of women with pure SUI, showing a very high cure rate and a low incidence of complications after 5-yr follow-up. |
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Authors:
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Maurizio Serati; Ricarda Bauer; Jean Nicolas Cornu; Elena Cattoni; Andrea Braga; Gabriele Siesto; Daphné Lizée; François Haab; Marco Torella; Stefano Salvatore |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-12-20 |
Journal Detail:
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Title: European urology Volume: - ISSN: 1873-7560 ISO Abbreviation: Eur. Urol. Publication Date: 2012 Dec |
Date Detail:
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Created Date: 2012-12-31 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7512719 Medline TA: Eur Urol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 European Association of Urology. Published by Elsevier B.V. All rights reserved. |
Affiliation:
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Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy. Electronic address: mauserati@hotmail.com. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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