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Tension-free vaginal tape procedure without preoperative urodynamic examination: Long-term outcome.
MedLine Citation:
PMID:  22725673     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objectives:  To evaluate the long-term outcome of the tension-free vaginal tape procedure. Methods:  A total of 191 patients were operated on with tension-free vaginal tape between January 1998 and May 2000. Of these, 127 (66%) had stress urinary incontinence, 64 (34%) had mixed urinary incontinence and 39 (20%) had recurrent incontinence. A total of 34 (18%) patients had had concomitant surgery. The diagnosis of incontinence was based on a history of leakage during stress and physical examination with a supine stress test in all patients. Tension-free vaginal tape was carried out under local (82%) or spinal (18%) anesthesia. After a mean of 10.5 years follow up, the assessment included a gynecological examination and a supine stress test. Subjective outcome was evaluated with Urinary Incontinence Severity Score, Detrusor Instability Score, visual analog scale, European quality of life-five dimensions, European quality of life - visual analog scale and short versions of Incontinence Impact Questionnaire-7 and Urogenital Distress Inventory-6. Objective cure was defined as a negative stress test and an absence of reoperation for incontinence during the follow up. Results:  A total of 138 (72%) of 191 patients were evaluated. Patients with minimally invasive surgery before operation had significantly higher scores in Urinary Incontinence Severity Score, Detrusor Instability Score, Incontinence Impact Questionnaire-7 and Urogenital Distress Inventory-6 at follow up than the patients with stress urinary incontinence (P < 0.01). Recurrent incontinence and concomitant surgery did not affect the long-term outcome. Three patients (2.3%) had late-onset adverse events. The objective and subjective cure rates were 90% and 78%, respectively. Conclusions:  The tension-free vaginal tape procedure is effective and safe even after 10 years. The objective cure rate is high, but the subjective outcome is significantly lower in mixed urinary incontinence patients compared with patients with pure stress urinary incontinence. Recurrent stress urinary incontinence does not affect the outcome, and tape-related problems are rare.
Authors:
Pia Heinonen; Seija Ala-Nissilä; Pentti Kiilholma; Eija Laurikainen
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-24
Journal Detail:
Title:  International journal of urology : official journal of the Japanese Urological Association     Volume:  -     ISSN:  1442-2042     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9440237     Medline TA:  Int J Urol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Japanese Urological Association.
Affiliation:
Turku University Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland.
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