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  • Title: Early outcomes of mid-urethral slings for female stress urinary incontinence stratified by valsalva leak point pressure.
    Author: O'Connor RC, Nanigian DK, Lyon MB, Ellison LM, Bales GT, Stone AR.
    Journal: Neurourol Urodyn; 2006; 25(7):685-8. PubMed ID: 16817185.
    Abstract:
    AIMS: To assess the early results of mid-urethral slings placed via the transobturator approach (TVT-O) for stress urinary incontinence (SUI) in women with high (>60 cm H(2)O) and low (<or=60 cm H(2)O) valsalva leak point pressure (VLPP). MATERIALS AND METHODS: Forty-three women with urodynamically proven SUI underwent TVT-O. Patients were divided into either high (>60 cm H(2)O) or low (<or=60 cm H(2)O) VLPP categories based on preoperative urodynamic studies. Patient outcomes were assessed based on degree of postoperative SUI as either dry (no pads, no SUI), or wet (any leakage). Follow-up visits were at 1, 6, 12, and 24 weeks. RESULTS: Overall, 65% (28/43) women were cured following TVT-O for SUI. When stratified based on preoperative VLPP, 77% (24/31) of patients with VLPP greater than 60 were cured while only 25% (3/12) of patients with VLPP less than or equal to 60 were cured. No intraoperative complications were noted. The odds of continued SUI following TVT-O were 12 times greater for women with VLPP <or=60 compared to those with VLPP >60. CONCLUSIONS: With limited follow up, TVT-O appears to be a safe and effective surgical treatment for female SUI producing excellent results in patients with VLPP >60 cm/H(2)0. Patients with low VLPP may consider conventional, retropubic mid-urethral slings or other procedures as treatment for SUI.
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