Article of the Week: TVT for treatment of pure urodynamic SUI
Every Week, the Editor-in-Chief selects an Article of the Week from the current issue of BJUI. The abstract is reproduced below and you can click on the button to read the full article, which is freely available to all readers for at least 30 days from the time of this post.
In addition to the article itself, there is an accompanying editorial written by a prominent member of the urological community. This blog is intended to provoke comment and discussion and we invite you to use the comment tools at the bottom of each post to join the conversation.
If you only have time to read one article this week, it should be this one.
Tension‐free vaginal tape for treatment of pure urodynamic stress urinary incontinence: efficacy and adverse effects at 17‐year follow‐up
To assess the efficacy and safety of retropubic tension‐free vaginal tape (TVT) 17 years after implantation for the treatment of female pure stress urinary incontinence (SUI).
Patients and Methods
A prospective study was conducted in two urogynaecological units in two countries. All consecutive women with urodynamically proven pure SUI treated by TVT were included. Patients with mixed incontinence and/or anatomical evidence of pelvic organ prolapse were excluded. Data regarding subjective outcomes (International Consultation on Incontinence Questionnaire–Short Form, Patient Global Impression of Improvement, and patient satisfaction scores), objective cure (stress test) rates, and adverse events were collected during follow‐up. Univariable analysis was performed to investigate outcomes.
A total of 52 women underwent TVT implantation. At 17‐year follow‐up, 46 women (88.4%) were available for the evaluation. We did not find any significant change in surgical outcomes during this time. At 17 years after surgery, 41 of 46 women (89.1%) declared themselves cured (P = 0.98). Similarly, at 17‐year evaluation, 42 of 46 women (91.4%) were objectively cured. No significant deterioration in objective cure rates was observed over time (P for trend 0.50). The univariate analysis did not find any risk factor statistically associated with the recurrence of SUI. Of the 46 women, 15 (32.6%) reported the onset of de novo overactive bladder at 17‐year follow‐up. No other late complications were reported.
The 17‐year results of this study showed that TVT is a highly effective and safe option for the treatment of SUI.
Comments are now closed for this article
The Nilsson study is one of the most flawed pieces of science I have read in my life. It has a 22% drop out rate. Even 5% introduces a severe risk of bias. Its two authors were paid consultants for Ethicon which make mesh. Oldest woman implanted was 87 and average age 52 so any new onset pain could be blamed on age. That is even if they asked about such things. Most trials only do the pad test QoL survey. If you dont need a pad you are fixed right? Wrong. It fixes SUI but brings with it a whole new raft of complications, Kath Sansom. Sling The Mesh @meshcampaign It is time patient voice was listened to wiht respect in the mesh implant disaster Look how much surgeons earn in private practice to put this stuff in £560 for a 20 minute day case TVT and £540 for a 2/3hr Burch requiring patient follow up for next couple of days. Go figure https://codes.bupa.co.uk/procedures