BERKELEY, CA (UroToday Inc.) - Nazia Munir and colleagues from London, UK performed a retrospective study comparing outcomes after treatment with tension-free vaginal tape (TVT) for stress urinary incontinence (SUI) as recorded by the physician in clinical notes and also as perceived by the patient through a questionnaire. Their findings were published in the May 2005 edition European Urology.

Information was obtained from patients undergoing a TVT procedure for SUI from February 1999 to December 2002. A chart review was performed to acquire demographic information, perioperative data and postoperative follow-up results as recorded by the physician. These patients were then sent a 14 question self administered satisfaction survey to determine their perception of their progress.

A total of 76 women were identified and analyzed. The mean age was 54 years (range, 25-85 years). 25% had a history of a previous surgery for incontinence and 25% had had a hysterectomy. All the patients had undergone preoperative urodynamic studies, with 89.5% having simple SUI and 10.5% have SUI and detrusor overactivity.

54 (72%) of the patients completed the patient questionnaire. 83% of these patients reported leaking urine several times per day preoperatively and 59% were either completely dry or leaked less than once a week postoperatively. 92% reported that their symptoms improved after the operation, while 8% said that there was no change. 80% reported more than a 75% improvement in symptoms, and 44% reported a 100% improvement. Interestingly, of those reporting a 100% improvement in symptoms, only 20% said they were completely dry. Overall, 94% of responders were satisfied with the procedure.

A review of the physicians records (clinic charts) of the 54 patients who completed the questionnaire revealed that 96% had an improvement in their symptoms. 46% reported being completely dry or 100% improved. 88% had an improvement of 75% or more.

The results as recorded by the patient questionnaire and office charts showed high satisfaction rates after TVT with the majority of patients having improved symptoms. The cure rates are similar for both methods of follow-up (44% by questionnaire vs. 46% by office chart), however they are lower than original reports of cure rates > 85%. There appeared to be a good association between the surgeon's and patient's perception of outcome.

The authors conclude that although there is an overall high satisfaction rate after TVT surgery, it does not necessarily translate into a high cure rate. Results from patient questionnaires and those collected from follow up visits in the office appear to show good correlation in assessing satisfaction and cure, therefore potentially eliminating the need for other more costly or invasive methods to assess results after surgery for SUI.

Eur Urol 2005; 47:635-640