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>or=25 kg/m2/BMI<25 kg/m2=68.3%:83.3%, p=0.044), low abdominal leak point pressure (ALPP<60 cm H2O/ALPP>or=60 cm H2O=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.