Erschienen in:
01.08.2006 | Original Article
Tension-free vaginal tape for the treatment of urodynamic stress incontinence with intrinsic sphincteric deficiency
verfasst von:
Fabio Ghezzi, Maurizio Serati, Antonella Cromi, Stefano Uccella, Stefano Salvatore, Paola Triacca, Pierfrancesco Bolis
Erschienen in:
International Urogynecology Journal
|
Ausgabe 4/2006
Einloggen, um Zugang zu erhalten
Abstract
The purpose of this study was to evaluate the outcome of tension-free vaginal tape (TVT) procedure in women with urodynamic stress incontinence diagnosed as having intrinsic sphincteric deficiency (ISD). The combination of a maximal urethral closure pressure <20 cm H2O and a Valsalva leak point pressure <60 cm H2O was considered as diagnostic of ISD. Subjects with detrusor overactivity on preoperative urodynamics were excluded. A total of 35 patients with both low closure pressure and leak point pressure were enrolled. Bladder perforation occurred in three (8.6%) cases. Postoperative urinary voiding difficulties occurred in nine (25.7%) women. Two patients underwent surgical detension of the tape, with complete resolution of urinary retention and no relapse of incontinence. Women with postoperative voiding dysfunction had a significantly lower detrusorial pressure at the peak flow on preoperative urodynamics compared to those who voided efficiently after TVT. The mean (range) follow-up time was 12.5 months (3–36). The objective cure rate for stress incontinence was 91.4%. Two of the three (66%) patients in whom the TVT procedure failed had a fixed urethra. De novo urge incontinence was found in five (14.3%) patients.