Voiding dysfunction following TVT procedure

Area of Science:

• Urology
• Gynecology
• Pelvic Floor Surgery

Background:

• Stress urinary incontinence (SUI) and mixed urinary incontinence (MUI) significantly impact women's quality of life.
• The tension-free vaginal tape (TVT) procedure is a common surgical intervention for SUI and MUI.

Purpose of the Study:

• To evaluate the incidence of abnormal voiding in patients following TVT placement.
• To identify factors associated with postoperative voiding dysfunction after TVT surgery.

Main Methods:

• A cohort of women who underwent TVT procedures were assessed for voiding habits, including frequency, urgency, nocturia, stream quality, and incontinence.
• Post-void residual (PVR) volume was measured via ultrasound, and pelvic examinations were conducted.
• Patients were categorized into 'normal' and 'abnormal' voiding groups based on predefined criteria.

Main Results:

• Out of 59 women, 42 (74%) had normal voiding and 15 (26%) had abnormal voiding.
• Urinary continence was achieved by 86% of patients (93% in the normal voiding group, 67% in the abnormal voiding group).
• Factors associated with abnormal voiding included abnormal preoperative uroflow, low preoperative peak flow rate, preoperative vault prolapse/enterocele, concurrent vault suspension surgery, and postoperative urinary tract infection (UTI).

Conclusions:

• The TVT sling procedure demonstrates comparable success and voiding dysfunction rates to other anti-incontinence procedures.
• Preoperative uroflow abnormalities and postoperative UTIs were identified as significant predictors of voiding dysfunction.
• Tension-free tape placement may not entirely prevent the development of postoperative voiding dysfunction.