| Predictive Factors Affecting Long-term Cure and Patient Satisfaction of the Tension-free Vaginal Tape Procedure for the Treatment of Female Stress Urinary Incontinence. |
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| Chin Kyung Doo, Jin Bum Kim, Wan Seok Kim, Jin Sung Park, Byung Joo Chung, Ji Yoon Kim, Hee Chang Jung, Kyu Sung Lee, Myung Soo Choo |
1Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, Korea. mschoo@amc.seoul.kr
2Department of Urology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.
3Department of Urology, Yeungnam University School of Medicine, Yeungnam University Hospital, Daegu, Korea. |
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| ABSTRACT |
PURPOSE
We evaluated predictive risk factors affecting the long-term efficacy of the tension-free vaginal tape(TVT) procedure for the treatment of female stress urinary incontinence(SUI).
MATERIALS AND METHODS
We included 138(mean age 52.4+/-9.3) women who underwent the TVT procedure and followed up for at least 5 years. We analyzed parameters including patient characteristics, history, physical examination, 1-hour pad test, and urodynamic studies using univariate and multivariate analyses with respect to the cure rates. The patients were regarded as cured in the absence of any episodes of involuntary urine leakage during stressful activities and stress cough test.
RESULTS
The overall 5-year cure rate was 76.8%, with an 86.9% patient satisfaction rate. On univariate and multivariate analyses, there were no significant parameters affecting the cure rate. The urgency negatively impacted patients' satisfaction(p=0.017, OR=4.114). According to the subgroup analyses, cure rates were lower in patients with high body mass index(BMI=25 kg/m(2), 68.3% vs 83.3%, p=0.044), lower Valsalva leak point pressure(VLPP<60 cmH2O, 51.6% vs 82.8%, p=0.003), and high-grade incontinence(40.0% vs. 69.7%, 86.6%, p=0.012).
CONCLUSION
the TVT procedure is an effective and safe surgery for SUI without any independent predictive factors affecting long-term cure execept urgency affecting satisfaction. However, higher BMI, low VLPP and high- grade incontinence may impair the efficacy of the TVT procedure. |
| Keywords:
Stress urinary incontinence; Tension-free vaginal tape; Predictive factors |
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