The Long Term (5-Years) Objective TVT Success Rate Does Not Depend on Predictive Factors at Multivariate Analysis: A Multicentre Retrospective Study

2008 
Abstract Objectives We evaluated the predictive risk factors that could affect the long-term efficacy of the tension-free vaginal tape (TVT) procedure for the treatment of female stress urinary incontinence (SUI). Methods One hundred thirty-eight (mean age, 52.4±9.3 yr) women who underwent the TVT procedure for SUI were selected and followed up for at least 5 yr (mean, 67.2 mo; range, 60–76) after the surgery. We analyzed the preoperative and intraoperative parameters using univariate and multivariate regression for cure rates and patients' satisfaction. Results The overall 5-yr cure rate was 76.8%, with a satisfaction rate of 86.9%. The cure rates were lower in patients with high body mass index (BMI≥25kg/m 2 /BMI 2 =68.3%:83.3%, p =0.044), low abdominal leak point pressure (ALPP 2 O/ALPP≥60cm H 2 O=51.6%:82.8%, p =0.003), and high grade of SUI (40.0% in grade III; 69.7% in grade II; 86.6% in grade I, p =0.012). On multivariate analysis, there were no independent risk factors related to cure rate, and urgency was the only factor independently associated with patients' satisfaction ( p =0.017; odds ratio=4.114). Conclusions This study demonstrates that the TVT procedure is effective for female SUI without any independent predictive factors affecting long-term cure rate. Urgency was the only predictive factor affecting patient satisfaction. However, high BMI, low ALPP, and high grade of incontinence may impair the cure rate of the TVT.
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