Over ten years of follow-up after the inside-out tension-free vaginal tape-obturator procedure: a prospective cohort study
IUGA Academy. Zhu L. Jun 30, 2018; 212800; 280 Topic: Stress Incontinence
Mrs. Lan Zhu
Mrs. Lan Zhu

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Over ten years of follow-up after the inside-out tension-free vaginal tape-obturator procedure: a prospective cohort study

Zhu, L1; Zhang, Y2; Song, XC2

1: Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, P.R. China; 2: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China.

Introduction: Inside-out tension free vaginal tape-obturator (TVT-O) is one of the most effective and safe surgical treatments for stress urinary incontinence (SUI). The available clinical outcome data for up to 10 years are limited to only two studies, and neither of these existing reports describe long-term outcomes over 10 years.

Objective: To evaluate the long-term safety and efficacy of TVT-O.

Methods: Between August 2004 and August 2007, 87 consecutive urodynamic stress incontinence (USI) patients who underwent TVT-O in our institution were enrolled into this prospective study. Patients with mixed incontinence or pelvic organ prolapse requiring surgery were excluded. The primary outcomes were long-term postoperative complications. The secondary outcomes included long-term objective cure rate, subjective cure rate, quality of life (QoL) and sexual function. The Incontinence Impact Questionnaire (IIQ-7) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) were used to assess QoL and sexual function, respectively. Statistical analyses were performed using paired-sample t-tests.

Results: At final visit, 73 patients (84%) were available for the evaluation, and the mean follow-up time was 11.8±2.5 years. Overall, long-term complication rate was 28.8%. De novo overactive bladder was evident in 12.3% of patients, and persistent groin pain was seen in 1.4% of patients. Tape exposure occurred in 5.5% of patients. The subjective and objective cure rates were 80.8% and 82.2%, respectively. Compared with preoperative scores, the IIQ-7 score decreased significantly (P<0.05), while no significant difference was noted in PISQ-12 scores (P=0.893).

Conclusion: Long-term follow up proved that inside-out tension free vaginal tape-obturator (TVT-O) is a safe and effective treatment for stress urinary incontinence, even after 12 years of follow-up.


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