The tension-free vaginal tape procedure: Correction of stress incontinencewith minimal alteration in proximal urethral mobility

Objectives. To prospectively assess the degree of urethral hypermobility in the preoperative and postoperative periods after the tension-free vaginal tape (TVT) procedure and correlate our findings with surgical outcome. Methods. Twenty patients with stress incontinence underwent the TVT procedu re. A Q-tip test was performed before the procedure and at the 3-week posto perative follow-up visit. Cure was defined as the absence of the subjective complaint of urine leakage and the absence of stress incontinence on stres s testing at cystometric capacity. Results. Seventeen patients (85%) were cured by the TVT procedure, 2 patien ts (10%) were improved, and 1 patient (5%) was unchanged. The mean preopera tive and postoperative Q-tip values were 42.75 degrees and 31.75 degrees, r espectively. Twelve patients had a a-tip test result of 30 degrees or great er after surgery and 1 1 (92%) of these 12 patients were cured by the proce dure. Conclusions. On the basis of these results, we propose that the cure of str ess incontinence does not require the correction of proximal urethral hyper mobility, UROLOGY 55: 512-514, 2000. (C) 2000, Elsevier Science Inc.