INTRODUCTION AND HYPOTHESIS:This study aims to identify independent risk factors for treatment failure of tension-free vaginal tape TVT-Secur (TVT-S) compared to that of the well-established transobturator tape.
MATERIALS AND METHODS: Of a total of 175 consecutive patients with urodynamically confirmed stress urinary incontinence (SUI) identified between July 2007 and March 2010, 89 patients underwent TVT-S, and 86 underwent TOT. Cure was defined using the Urogenital Distress Inventory as no urinary leakage during physical activity, coughing, or sneezing as reported by patients during a telephone survey. To identify predictors of treatment failure, multivariable logistic regression models were used, and odds ratios (ORs) were calculated using variables identified during univariate analysis.
RESULTS: There were more patients with cystocele ≥ grade 2 in the TVT-S group (p = 0.031); otherwise the groups were well matched. After a median follow-up of 32 months (range, 12-44 months), the overall cure rate was 80.6%; it was 70.8% for those treated with TVT-S and 90.7% for those treated with TOT (p = 0.001). In a multivariate model, previous incontinence surgery (OR 27.1, p = 0.005) and a cystocele ≥ grade 2 (OR 3.0, p = 0.020) were independent risk factors influencing the outcome of TVT-S procedures. For the TOT procedures, detrusor overactivity was an independent risk factor in a multivariate model (OR 8.6, p = 0.033).
CONCLUSIONS: TVT-S could be performed for selected patients, but conventional TOT procedures are still superior to the novel TVT-S device.
Written by:
Hwang E, Shin JH, Lim JS, Song KH, Sul CK, Na YG. Are you the author?
Department of Urology, Sun General Hospital, Daejeon, South Korea.
Reference: Int Urogynecol J. 2012 Feb 10. Epub ahead of print.
doi: 10.1007/s00192-012-1687-1
PubMed Abstract
PMID: 22322204
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