Tension-free vaginal tape for the treatment of urodynamic stress incontinence with intrinsic sphincteric deficiency

Fabio Ghezzi, Maurizio Serati, Antonella Cromi, Stefano Uccella, Stefano Salvatore, Paola Triacca, Pierfrancesco Bolis

Research output: Contribution to journalArticle

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 2O and a Valsalva leak point pressure 2 O 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.

Original languageEnglish
Pages (from-to)335-339
Number of pages5
JournalInternational Urogynecology Journal and Pelvic Floor Dysfunction
Volume17
Issue number4
DOIs
Publication statusPublished - Aug 2006

Keywords

  • Intrinsic sphincteric deficiency
  • Maximal urethral closure pressure
  • Stress urinary incontinence
  • TVT
  • Valsalva leak point pressure

ASJC Scopus subject areas

  • Urology
  • Obstetrics and Gynaecology

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