Ten-Year Followup after Tension-Free Vaginal Tape-Obturator Procedure for Stress Urinary Incontinence

J Urol. 2016 Oct;196(4):1201-6. doi: 10.1016/j.juro.2016.05.036. Epub 2016 May 13.

Abstract

Purpose: Suburethral tapes are a standard surgical treatment for stress urinary incontinence. The aim of the study was to evaluate subjective and objective cure rates 10 years after a tension-free vaginal tape-obturator procedure.

Materials and methods: All 124 patients who underwent the tension-free vaginal tape-obturator procedure at a total of 2 centers in 2004 and 2005 were invited for followup. Objective cure was defined as a negative cough stress test at 300 ml. Subjects completed KHQ (King's Health Questionnaire), IOQ (Incontinence Outcome Questionnaire), FSFI (Female Sexual Function Index Questionnaire) and PGI-I (Patient Global Impression of Improvement).

Results: Overall, 55 of 112 women (49%) who were alive were available for clinical examination and 71 (63%) completed the questionnaires. The objective cure rate in the 55 women examined clinically was 69%, 22% were not cured and 9% (5) had undergone reoperation for recurrent or persistent stress urinary incontinence. Treatment was counted as having failed in these 5 women for study purposes. Subjective cure was reported by 45 of 71 women (64%). Three patients (5%) had vaginal tape extrusion at the time of clinical examination. Extrusion in all of them was small and asymptomatic, and did not require treatment for a cumulative extrusion rate of 7%. Six women (9%) had undergone reoperation for tension-free vaginal tape-obturator associated complications and 18 (26%) experienced de novo overactive bladder.

Conclusions: Subjective and objective cure rates 10 years after the tension-free vaginal tape-obturator procedure were 69% and 64%, respectively. The vaginal extrusion rate in this study was slightly higher than in other series but major long-term complications appeared to be rare.

Keywords: complications; patient outcome assessment; suburethral slings; urethra; urinary incontinence, stress.

Publication types

  • Multicenter Study

MeSH terms

  • Follow-Up Studies
  • Forecasting*
  • Humans
  • Male
  • Middle Aged
  • Quality of Life*
  • Retrospective Studies
  • Suburethral Slings*
  • Surveys and Questionnaires*
  • Treatment Outcome
  • Urinary Incontinence, Stress / physiopathology
  • Urinary Incontinence, Stress / surgery*
  • Urodynamics / physiology*
  • Urologic Surgical Procedures / methods*