The use of tension-free vaginal tape associated with pelvic floor reconstructive surgery

To present our medium-to-long term results for the use of TVT in female stress urinary incontinence (SUI) employed concomitantly with surgical correction of pelvic floor prolapse for an integral solution.

Between January 2000 and May 2008, 171 women with pelvic floor disorders underwent a surgical procedure with TVT. 117 of those women received TVT as a sole treatment for SUI. In the remaining 54 patients, who suffered from some type of pelvic organ prolapse, TVT was combined with a vaginal procedure to correct the prolapse (cystocele, rectocele, prolapsed uterus).

Mean follow-up time was 36 months (range 12-108). The mean age was 55 years (35-78) in the TVT group (group 1) and 57 years (range 43-76) in the TVT and pelvic floor correction group (group 2). The number of childbirths was 2.23 (range 0-6) in group 1 and 3.12 (1-6) in group 2. There were some differences in the initial medical complaints in both groups. Mean hospitalisation time was 24 hours in group 1 and 4 days in group 2. The most serious complication was bladder perforation during surgery, which occurred in seven patients. The most frequent complication was the onset of de novo detrusor overactivity (overactive bladder), which was similar in both groups.

TVT is the reference standard treatment for female SUI with proven results in the literature. Its association with reconstructive surgery is presented as a safe and satisfactory alternative for comprehensive resolution of pelvic floor defects, without increasing the morbidity of the technique.