Tension-Free Vaginal Tape (TVT) for the treatment of occult stress urinary incontinence in women undergoing prolapse repair: A prospective study of 100 consecutive cases

Asnat Groutz, Ronen Gold, David Pauzner, Joseph B. Lessing, David Gordon

Research output: Contribution to journalArticlepeer-review

Abstract

Aims: Clinically continent women with genitourinary prolapse and occult stress urinary incontinence (SUI) are considered to be at high risk of developing symptomatic SUI once the prolapse is repaired. We studied the efficacy and safety of tension-free vaginal tape (TVT) procedure in preventing postoperative SUI in these women. Methods: One hundred consecutive women (mean age 66.7 ± 9.9 years) with significant genitourinary prolapse and occult SUI were prospectively enrolled. Preoperatively, none of the women complained of SUI. However, all had urodynamically-confirmed occult SUI, revealed by repositioning of the prolapse. Surgical intervention was comprised of transvaginal prolapse repair and prophylactic TVT procedure. Main outcome end points included operative morbidity, postoperative SUI, persistent or de novo urge incontinence, and voiding dysfunction. Results: The mean follow-up period was 27 months (range: 12-52 months). There was only one case of technique-related bladder perforation with no adverse outcome. Two other patients had post-operative urinary retention necessitating catheterization for more than 7 days, none of whom required any surgical intervention. Vaginal erosion of the tape was diagnosed in three patients, all of whom were successfully treated by excision of the eroded tape. Two (2%) patients developed urodynamically-confirmed SUI within 1 year postoperatively. However, postoperative urodynamics revealed asymptomatic sphincteric incontinence in 15 (15%) other patients. Thirteen (72%) of 18 patients with preoperative urge incontinence had postoperative persistent urge incontinence. De novo urge incontinence developed postoperatively in 8 (8%) patients. Conclusions: TVT procedure is effective and safe in patients with occult SUI undergoing prolapse repair. Long-term durability of this procedure is yet to be established.

Original languageEnglish
Pages (from-to)632-635
Number of pages4
JournalNeurourology and Urodynamics
Volume23
Issue number7
DOIs
StatePublished - 2004

Keywords

  • Occult stress urinary incontinence
  • Outcome results
  • Prolapse
  • TVT

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