Tension-free vaginal tape for primary genuine stress incontinence: a two-centre follow-up study

Objective To assess the safety and efficacy of the tension-free vaginal tap e procedure in the treatment of primary genuine stress incontinence. Patients and methods A two-centre follow-up study was conducted on 40 women with urodynamically confirmed primary genuine stress incontinence who had a tension-free vaginal tape inserted under local anaesthesia with sedation. Operative details were recorded and all patients followed up both subjecti vely, and objectively with repeat urodynamic studies and pad testing. Results The mean (range) age of the women was 51.1 (33-86) years, the media n parity 2 (0-4) and mean body mass index 25.1 (19-35). The mean anaesthesi a and operative duration was 42 (25-65) min: 93% of the women resumed immed iate spontaneous voiding with no need for catheterization. The mean inpatie nt stay was 2.2 (2-4) days (where 2 days is equivalent to one night in hosp ital). The follow-up was conducted at a mean interval of 12.3 (6-24) months . Subjectively, 80% of women were cured and 17.5% significantly improved; o bjectively, genuine stress incontinence was cured in 95%. Symptomatic posto perative detrusor instability was found in 15% of women and symptoms of voi ding dysfunction identified in 5% of women. There were no defects in healin g or tape rejection. Conclusion The tension-free vaginal tape procedure is a promising new techn ique that, in this short-term analysis, appears to be safe and effective. I ntraoperative complications are uncommon and both hospital stay and recover y are short. Voiding complications are rare but symptomatic postoperative d etrusor instability had an incidence of 15%.