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  • Title: Tension-free vaginal tape (TVT) for treatment of stress urinary incontinence in women with low-pressure urethra.
    Author: Meschia M, Pifarotti P, Buonaguidi A, Gattei U, Spennacchio M.
    Journal: Eur J Obstet Gynecol Reprod Biol; 2005 Sep 01; 122(1):118-21. PubMed ID: 16154048.
    Abstract:
    OBJECTIVE: To assess the results of TVT in patients with urinary stress incontinence, urethral hypermobility, and low-pressure urethra. STUDY DESIGN: We retrospectively analysed 265 consecutive women who underwent a TVT procedure for urodynamic stress urinary incontinence over a 31-month period. Women were divided into two groups depending on their preoperative maximum urethral closure pressure (MUCP). Group 1 (61 women with MUCP<or=20 cm H2O) were compared with 204 women (group 2) with a MUCP>20 cm H2O. Subjective and objective outcome data were assessed from routine postoperative visits. Office and hospital records were reviewed to check patients' characteristics, intraoperative findings, and surgical outcomes. RESULTS: Women with low-pressure urethra were older than those with MUCP>20 cm H2O; they were more likely to have had a hysterectomy or anti-incontinence surgery. The mean duration of follow-up was 31 (+/-11) months. Cure rates among patients with low- or normal-pressure urethra were similar (77% and 86%, P=0.70). Nevertheless, the former were more likely to complain of voiding dysfunction. CONCLUSION: TVT is a highly effective treatment even in women with intrinsic sphincter deficiency.
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