Methods

In 2004, 100 patients with genuine stress urinary incontinence underwent surgery by the TVT procedure. Preoperative and postoperative urodynamic study was performed for each patient. Postoperatively, patients’ perception of result and quality of life were assessed on two validated scales, namely, Mesure du Handicap Urinaire (MHU) and Ditrovie. Voiding dysfunction was defined by a postoperative peak flow rate of <15ml/s at 3 mo. Clinical and urodynamic parameters were compared and analysed.

Results

At 3 mo, 20 patients (20%) showed evidence of voiding dysfunction despite the absence of clinical symptoms in 14 of them (70%). Multivariate analysis showed that age (p<0.038) and preoperative peak flow rate (p<0.001) were independent risk factors for voiding dysfunction. Parity, menopausal status, body mass index, and maximal urethral closure pressure were not statistically related to the risk of voiding dysfunction.

Conclusions

This study confirms the existence of an important rate of postoperative voiding dysfunction, mostly asymptomatic, and identifies age and preoperative maximal peak flow rate as independent preoperative risk factors. Identification of voiding dysfunction in patients may lead to better follow-up and early detection of late potential complications of suburethral procedures.

Ambroise Salin, Sophie Conquy, Caroline Elie, Cyril Touboul, Jérome Parra, Marc Zerbi, Bernard Debré, Delphine Amsellem-Ouazana

Université Paris-Descartes, Faculté de Médecine, AP-HP, Hôpital Cochin, Department of Urology, Paris, France
Université Paris-Descartes, Faculté de Médecine, AP-HP, Hôpital Cochin, Department of Biostatistics, Paris, France

Accepted 23 October 2006 published online 10 November 2006.

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