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Tension-free vaginal tape in the management of recurrent urodynamic stress incontinence after previous failed midurethral tape.

Abstract：

BACKGROUND:Data about the use of tension-free vaginal tape (TVT) in the management of recurrent urodynamic stress incontinence (RUSI) after previous failed midurethral sling procedure (MUSP) are limited. OBJECTIVE:Assessment of the efficacy and the indications of the TVT procedure in the management of patients with RUSI after failed previous MUSP. DESIGN, SETTING, AND PARTICIPANTS:Thirty-one patients with RUSI after previous failed MUSP were prospectively enrolled at a single tertiary academic center. MEASUREMENTS:Preoperatively and postoperatively, patients were assessed with physical examination, urinalysis, urine culture, bladder diary for 2-3 d, Q-tip test, uroflow, filling and voiding cystometry, urethral profilometry, and 1-h pad test. Mean follow-up was at 18.6 mo (range: 12-28 mo). RESULTS AND LIMITATIONS:Overall, the objective cure rate based on the pad test findings was 74%, the improvement rate was 6.5%, and the failure rate was 19.5%. The objective cure rate based on cough stress test during filling cystometry was 77.4%, and the subjective cure rate based on patients' answers was 71%. The study could have some limitations. The relatively small number of patients enrolled could affect the findings of study to some degree. Additionally, because urethral pressure profiles show a significant degree of directional dependence when side-hole microtip transducers are used, as in the present study, the orientation of the transducer could affect the values measured. CONCLUSIONS:The TVT procedure as a second operation could provide an overall cure rate of 74% with a low complication rate in female patients with RUSI after previous failed midurethral tape procedures.

journal_name

Eur Urol

journal_title

European urology

authors

Liapis A,Bakas P,Creatsas G

doi

10.1016/j.eururo.2009.03.025

subject

Has Abstract

pub_date

2009-06-01 00:00:00

pages

1450-5

issue

6

eissn

0302-2838

issn

1873-7560

pii

S0302-2838(09)00265-6

journal_volume

55

pub_type

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