Subjective outcome of 166 tension-free vaginal tape procedures performed by a single surgeon: the Braemar experience

Long-term outcomes of the tension-free vaginal tape (TVT) procedure are needed to assess its efficacy.

This was a cross-sectional study of the subjective outcome in patients with stress urinary incontinence (SUI) operated on consecutively by a single surgeon. Success was defined as the absence of SUI at the time of the study. The validated questionnaires Urogenital Distress Inventory-6 (UDI-6) and Incontinence Impact Questionnaire (IIQ-7) were used to find the minimum important difference (MID) to support subjective reports of success.

One hundred and sixty-six patients were evaluated with a mean follow-up time of 58 ± 28.6 months. Fifty-five (33.1%) patients underwent the TVT procedure alone, and 111 (66.9%) underwent the TVT procedure with concomitant pelvic organ prolapse (POP) repair. One hundred and thirty-three (80.1%) patients reported being subjectively cured with no stress incontinence at the time of the study. A total of 138 (83.1%) patients reported an MID > 11 points when comparing the postoperative to the pre-operative UDI-6 scores. A total of 122 (73.5%) patients reported an MID > 16 points when comparing the postoperative to the pre-operative IIQ-7 scores. There was no evident decline in the yearly percentage of patients who achieved an MID > 11 or MID > 16 in the UDI-6 and IIQ-7 scores, respectively.

The TVT procedure in a population in which 67% underwent a concomitant POP repair was associated with a subjective cure rate of 80% and an MID > 11 in 82.7% of patients in the UDI-6 questionnaire and an MID > 16 in 75.1% patients in the IIQ-7 questionnaire.

The Australian & New Zealand journal of obstetrics & gynaecology. 2016 Jun 21 [Epub ahead of print]

Jose D Roman

Department of Gynaecology, Braemar Hospital, Hamilton, New Zealand.