An assessment of the early surgical (outcome and urodynamic effects of thetension-free vaginal tape (TVT)

Fifty-two women underwent a tension-free vaginal tape (TVT) procedure for g enuine stress incontinence (GSI). Preoperative assessment included a detail ed medical history, pelvic examination, a 1-hour pad test with a comfortabl y full bladder, and urinary culture. Thirteen of the 52 women were excluded for various reasons. Both before and 12-24 months post-operatively all pat ients had a full urodynamic investigation using microtip transducer cathete rs. The study subjects were instructed to maintain a 1-week baseline urinar y diary 1 week before the operation, and post-operative urodynamic assessme nt as well. The period of follow-up ranged from 12 to 24 months (median 19 months). Another 1-hour pad test with a comfortably full bladder and urinar y culture were carried out thereafter. Comparisons of the 39 women pre- and postoperatively found a significantly improved 1-hour pad test (34.9 +/- 3 4.7 vs 8.3 +/- 24.0. P<0.001). Analyzing the urodynamic effects of surgery revealed no significant postoperative changes except for the maximal urethr al closure pressure (MUCP) at rest. An objective assess ment using a pad te st revealed the success rate (cure plus improved) to be 90% (35/39) and the failure rate 10% (4/39). TVT can thus be considered a safe and effective p rocedure for GSI in women. Moreover, the urodynamic effects of surgery were not found to be critical to success.