Several minimally invasive surgical procedures have been developed in recent years to manage urinary stress incontinence in women. These procedures have had low cure rates and high complication rates. The tension-free vaginal tape procedure has had good functional results with low rates of complications in several types of incontinence. Nilsson and colleagues evaluated the long-term results of the tension-free vaginal tape procedure for the treatment of urinary stress incontinence in women.
The authors studied 90 women who underwent a tension-free vaginal tape procedure for urodynamically diagnosed stress incontinence. Postoperative assessment variables included a stress test, a 24-hour pad-weighing test, a two-day voiding diary, and a standardized visual analog scale to assess quality of life and impact of urinary conditions. A gynecologic examination was performed, and changes in medical history and each woman’s subjective assessment of her incontinence were recorded.
Sixty-four women were available for complete assessment at the seven-year follow-up visit. An additional 16 women could not attend for clinical evaluation but contributed subjective data to the study. For the 80 women who could be questioned, 65 patients (81.3 percent) considered their incontinence cured, and 13 patients (16.3 percent) reported that their condition was improved by the surgery. Of the 64 women who were clinically evaluated, 54 (84.4 percent) had a negative pad test, and 61 (95.3 percent) had a negative stress test. No reports or evidence of urinary obstruction or tape rejection was found, but five women (6.3 percent) reported new symptoms of urge incontinence, and six women (7.5 percent) reported recurrent urinary tract infections.
The authors conclude that the tension-free vaginal tape procedure for the treatment of urinary stress incontinence in women is effective over a period of seven years.