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Related Experiment Videos

Voiding function after tension-free vaginal tape: a longitudinal study.

Hans Peter Dietz1, Gaye Ellis, Peter Donald Wilson

  • 1Women and Babies, Royal Prince Alfred Hospital, Sydney, Australia. hpdietz@bigpond.com

The Australian & New Zealand Journal of Obstetrics & Gynaecology
|April 20, 2004
PubMed
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The tension-free vaginal tape (TVT) procedure for stress incontinence can initially reduce maximum flow rate but improves voiding symptoms and flow over time. This surgical treatment for incontinence shows long-term benefits for bladder emptying and related symptoms.

Area of Science:

  • Urology
  • Gynecology
  • Pelvic Floor Surgery

Background:

  • Tension-free vaginal tape (TVT) is a popular surgical treatment for urodynamic stress incontinence.
  • Its effect on voiding function remains debated, with imaging suggesting an obstructive component.

Purpose of the Study:

  • To longitudinally evaluate flowmetry indices and voiding symptoms following TVT placement.
  • To assess the long-term impact of TVT on bladder outlet obstruction and patient-reported voiding dysfunction.

Main Methods:

  • 145 patients undergoing TVT placement were followed annually, with 108 attending at least two follow-ups.
  • Standardized questionnaires, clinical stress tests, uroflowmetry, and translabial ultrasound for residual urine were performed.

Main Results:

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  • Maximum flow rate (MFR) centiles initially decreased post-TVT but significantly increased between the first and last postoperative visits.
  • Residual urine volumes decreased significantly, alongside reported improvements in 'poor stream,' 'straining to void,' and 'incomplete emptying.'

Conclusions:

  • TVT placement can reduce MFR and potentially cause a mild obstructive effect on voiding.
  • Voiding function and symptoms of dysfunction appear to improve over time after TVT surgery, suggesting a favorable long-term outcome.