Tension-free vaginal tape for stress incontinence safe, effective in long term

Among women with stress urinary incontinence, the retropubic tension-free vaginal tape (TVT) retains its efficacy up to 24 years after initial placement, with adverse effects being uncommon and having a low impact on quality of life, according to a study.

The single-centre study consisted of 350 women who had a TVT inserted between 1999 and 2004. Researchers used the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) questionnaire to evaluate the primary outcome of cure of stress urinary incontinence. They also looked at overactive bladder symptoms, pain, sexual dysfunction, and patient satisfaction with the procedure.

The median age of the population was 67 years, and the median follow-up was 20 years. All women underwent urodynamic studies prior to their initial TVT procedure, and the results showed that 337 of them (96.3 percent) had urodynamic stress incontinence, among whom 57 had concomitant detrusor overactivity.

A total of 171 (93.4 percent) women reported experiencing no stress incontinence by week 6 postsurgery. This translated to a 54.1-percent increase from 72 women (39.3 percent) at baseline.

During the follow-up, symptoms of urgency were quite common, being reported by 42.1 percent of women. However, nocturia and frequency were low. Likewise, although 40 percent of women reported urge urinary incontinence, the associated bother scores were near zero.

About 92 percent of women reported that they either “never” or “occasionally” experience bladder pain. The median satisfaction rate was high (98/100), with 92.4 percent of women saying they would choose to have the TVT procedure again.