UROLOGICAL SURVEY
NEUROLOGY & FEMALE UROLOGY
Long-term subjective results of tension-free vaginal tape operation for female urinary stress incontinence
Glavind K; Glavind E; Fenger-Grøn M
Department of Gynecology and Obstetrics, Aalborg Hospital, 9000, Aalborg, Denmark
Int Urogynecol J. 2011; 18. [Epub ahead of print]
INTRODUCTION AND HYPOTHESIS: The aim of the study was to evaluate the subjective outcome between 1 and 5 years after tension-free vaginal tape (TVT) operation and the need for follow-up.
METHODS: A prospective questionnaire study was performed including questions about incontinence, urinary tract infection, emptying problems, the wish for a clinical control and the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF).
RESULTS: One hundred seventy-three patients were included. There were more patients with subjective recurrent stress incontinence over the years, but ICIQ-SF was unchanged. There was no rise in patients reporting urge incontinence over the years. Only 11.4% of the patients wished for a clinical control at some time.
CONCLUSION: The TVT operation showed a slight degree of subjective deterioration between 1 and 5 years after the operation; however, the ICIQ-SF was unchanged. There seems to be no need for long-term follow-up at the operating department.
Editorial Comment
This is an interesting paper by Glavind et al. aiming to show sustained results after TVT operation for treating female stress urinary incontinence (SUI) from 3 months up to 5 years of follow-up. Their idea is to question the need for such long follow-up.
They analyzed 173 patients and present an increase from 12.2% to 26.7% in recurrent SUI comparing 3 mo x 5 years results with an odds ratio (OR) of 1.38. A similar finding occurred for subjective complaints regarding difficulty to empty the bladder (8.6% to 26.7% for 3 mo and 5 years, respectively, with a yearly OR of 1.57). However, the drop out rate of 38% during long term follow-up seems unacceptably high (81 x 51 patients at 3 mo and 5 years). Despite this it is interesting to note that ICIQ-SF scores did not rise throughout time and only 11% of patients requested a clinical control over time. The authors conclude suggesting no need for clinical control or postal questionnaires after a normal visit at 3 mo after surgery; as no patient presented a major complication or need for surgical revision following long term clinical control. I would point out this should be seen with caution as slow flow was reported by half of patients at 1 and 5 years of follow up and no objective exam was performed to diagnose a possible obstructive flow. Also, ICIQ-SF does not take this matter into account.
Dr. Ricardo Miyaoka
State University Campinas
Campinas, SP, Brazil
E-mail: rmiyaoka@uol.com.br
Publication Dates
-
Publication in this collection
16 Feb 2012 -
Date of issue
Dec 2011
