Document Detail


Tension-free vaginal tape for the treatment of urodynamic stress incontinence with intrinsic sphincteric deficiency.
MedLine Citation:
PMID:  16211315     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The purpose of this study was to evaluate the outcome of tension-free vaginal tape (TVT) procedure in women with urodynamic stress incontinence diagnosed as having intrinsic sphincteric deficiency (ISD). The combination of a maximal urethral closure pressure < 20 cm H2O and a Valsalva leak point pressure < 60 cm H2O was considered as diagnostic of ISD. Subjects with detrusor overactivity on preoperative urodynamics were excluded. A total of 35 patients with both low closure pressure and leak point pressure were enrolled. Bladder perforation occurred in three (8.6%) cases. Postoperative urinary voiding difficulties occurred in nine (25.7%) women. Two patients underwent surgical detension of the tape, with complete resolution of urinary retention and no relapse of incontinence. Women with postoperative voiding dysfunction had a significantly lower detrusorial pressure at the peak flow on preoperative urodynamics compared to those who voided efficiently after TVT. The mean (range) follow-up time was 12.5 months (3-36). The objective cure rate for stress incontinence was 91.4%. Two of the three (66%) patients in whom the TVT procedure failed had a fixed urethra. De novo urge incontinence was found in five (14.3%) patients.
Authors:
Fabio Ghezzi; Maurizio Serati; Antonella Cromi; Stefano Uccella; Stefano Salvatore; Paola Triacca; Pierfrancesco Bolis
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2005-10-07
Journal Detail:
Title:  International urogynecology journal and pelvic floor dysfunction     Volume:  17     ISSN:  -     ISO Abbreviation:  Int Urogynecol J Pelvic Floor Dysfunct     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-06-02     Completed Date:  2006-11-21     Revised Date:  2011-08-18    
Medline Journal Info:
Nlm Unique ID:  9514583     Medline TA:  Int Urogynecol J Pelvic Floor Dysfunct     Country:  England    
Other Details:
Languages:  eng     Pagination:  335-9     Citation Subset:  IM    
Affiliation:
Urogynecologic Unit, Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy. fabio.ghezzi@uninsubria.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Female
Gynecologic Surgical Procedures / methods*
Humans
Middle Aged
Pressure
Surgical Mesh / adverse effects*
Treatment Outcome
Urinary Incontinence, Stress / surgery*
Urodynamics
Vagina / surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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