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Related Experiment Videos

Factors predictive of post-TVT voiding dysfunction.

Tim Dawson¹, Vanessa Lawton, Elisabeth Adams

¹Department of Urogynaecology, Liverpool Women's Hospital, Crown St., Liverpool L87SS, UK. TIMOTHY.DAWSON@lwh.nhs.uk

International Urogynecology Journal and Pelvic Floor Dysfunction

|March 10, 2007

Summary

A tension-free vaginal tape (TVT) procedure can cause voiding dysfunction in 8% of women, requiring intermittent self-catheterisation (ISC). Lower average voiding flow rate centile scores strongly predict this post-TVT complication.

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Area of Science:

Urology
Gynecology
Pelvic Floor Disorders

Background:

Urinary incontinence affects many women, with surgical interventions like the tension-free vaginal tape (TVT) procedure being common treatments.
Voiding dysfunction, including difficulty emptying the bladder, can be a complication following anti-incontinence surgery.
Identifying predictive factors for post-operative voiding dysfunction is crucial for patient selection and surgical counseling.

Purpose of the Study:

To determine the incidence of voiding dysfunction after a tension-free vaginal tape (TVT) procedure.
To identify patient, urodynamic, and surgical factors associated with the need for intermittent self-catheterisation (ISC) post-TVT.

Main Methods:

A cohort of 267 women who underwent TVT surgery was assessed 6 months post-operatively.
Logistic regression analysis was employed to identify factors associated with the need for ISC.
Patient demographics, urodynamic data, and surgical variables were analyzed.

Main Results:

8% (22 out of 267) of women required daily intermittent self-catheterisation (ISC) due to voiding dysfunction after TVT.
Menopausal status, prior incontinence surgery, and a low centile score for average voiding flow rate were individually associated with ISC need.
Multivariate analysis revealed that the average voiding flow rate centile score was the strongest predictor, with lower scores indicating a higher likelihood of needing ISC.

Conclusions:

Voiding dysfunction requiring ISC is a significant complication after TVT surgery, occurring in 8% of women.
A low average voiding flow rate centile score, assessed pre-operatively, is a strong predictor of post-TVT voiding dysfunction.
This flow rate assessment may aid in selecting appropriate candidates for the TVT procedure to minimize the risk of voiding dysfunction.