Tension-free vaginal tape and associated procedures: a case control study

Area of Science:

• Urogynecology
• Pelvic Reconstructive Surgery
• Minimally Invasive Gynecological Surgery

Background:

• Stress urinary incontinence (SUI) is a common condition affecting women's quality of life.
• The tension-free vaginal tape (TVT) procedure is a widely used surgical option for SUI.
• Concomitant vaginal procedures may be considered for women with coexisting pelvic floor defects or uterine disorders.

Purpose of the Study:

• To compare objective and subjective cure rates of the tension-free vaginal tape procedure when performed alone versus in conjunction with vaginal hysterectomy or pelvic floor reconstruction.
• To evaluate surgical outcomes, including difficulties and complications, for these different surgical approaches.

Main Methods:

• A comparative study involving 186 women undergoing tension-free vaginal tape procedures for SUI.
• Group 1: TVT alone (n=100).
• Group 2: TVT with vaginal hysterectomy (n=40).
• Group 3: TVT with pelvic floor reconstruction (n=46).
• Outcomes assessed included postoperative voiding diaries, standing stress tests, and patient satisfaction.

Main Results:

• No significant differences in objective cure rates (93% vs. 97.5% vs. 91.1%) or subjective cure rates (72% vs. 72.5% vs. 68.8%) were observed among the three groups.
• Higher incidence of bladder injury in groups undergoing concomitant procedures (17.9% and 13%) compared to TVT alone (5%).
• No significant differences in age, BMI, menopausal status, or previous incontinence surgery between groups.

Conclusions:

• Tension-free vaginal tape procedures combined with vaginal hysterectomy or pelvic floor reconstruction offer comparable cure rates to TVT alone for stress urinary incontinence.
• These combined procedures can be safely performed to address pelvic floor defects, benign uterine disorders, and SUI simultaneously.
• While bladder injury rates were higher with combined procedures, overall outcomes remained favorable.