Ten-Year Subjective Outcome Results of the Retropubic Tension-Free Vaginal Tape for Treatment of Stress Urinary Incontinence

Study Objective: To assess the 10-year subjective outcome of use of retropubic tension-free vaginal tape (TVT). Design: Structured telephone interview (Canadian Task Force classification II-3). Setting: Universitiy-affiliated tertiary medical center. Patients: Sixty consecutive women with urodynamically confirmed stress urinary incontinence (SUI) who underwent retropubic TVT surgery during 2000. At surgery, their mean (SD) age was 62.4 (9.3) years, and parity was 2.9 (1.3). Interventions: Retropubic TVT, with 10-year subjective outcome questionaire. Measurements and Main Results: Of the 60 patients, 52 (87%) were available for 10-year follow-up. Preoperatively, all patients reported substantial SUI, and 28 (54%) also had concomitant urge urinary incontinence (UUI). At 10 years postoperatively, 34 women (65%) considered their condition cured, 6 (12%) believed it was improved, and 12 (23%) thought surgery had failed. Eleven women (21%) reported SUI, 22 (42%) had UUI (de novo UUI in 9), and 8 (15%) had recurrent urinary tract infections. Two women (4%) underwent repeated TVT. Of the various perioperative variables, only postoperative impaired bladder emptying was a statistically independent risk factor for long-term failure (odds ratio, 6.4; 95% confidence interval, 1.3-30.1). Conclusions: Ten-year subjective outcome of retropubic TVT are less favorable than previously reported. Early postoperative impaired bladder emptying is the most significant risk factor for long-term failure.