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

37 Citations (Scopus)

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

Fingerprint

Suburethral Slings
Urodynamics
Pressure
Surgical Tape
Urge Urinary Incontinence
Therapeutics
Urinary Retention
Urethra
Urinary Bladder
Recurrence

Keywords

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

ASJC Scopus subject areas

  • Urology
  • Obstetrics and Gynaecology

Cite this

Tension-free vaginal tape for the treatment of urodynamic stress incontinence with intrinsic sphincteric deficiency. / Ghezzi, Fabio; Serati, Maurizio; Cromi, Antonella; Uccella, Stefano; Salvatore, Stefano; Triacca, Paola; Bolis, Pierfrancesco.

In: International Urogynecology Journal and Pelvic Floor Dysfunction, Vol. 17, No. 4, 08.2006, p. 335-339.

Research output: Contribution to journalArticle

Ghezzi, Fabio ; Serati, Maurizio ; Cromi, Antonella ; Uccella, Stefano ; Salvatore, Stefano ; Triacca, Paola ; Bolis, Pierfrancesco. / Tension-free vaginal tape for the treatment of urodynamic stress incontinence with intrinsic sphincteric deficiency. In: International Urogynecology Journal and Pelvic Floor Dysfunction. 2006 ; Vol. 17, No. 4. pp. 335-339.
@article{92eb8e93429645bfae042109f65f2dc4,
title = "Tension-free vaginal tape for the treatment of urodynamic stress incontinence with intrinsic sphincteric deficiency",
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.",
keywords = "Intrinsic sphincteric deficiency, Maximal urethral closure pressure, Stress urinary incontinence, TVT, Valsalva leak point pressure",
author = "Fabio Ghezzi and Maurizio Serati and Antonella Cromi and Stefano Uccella and Stefano Salvatore and Paola Triacca and Pierfrancesco Bolis",
year = "2006",
month = "8",
doi = "10.1007/s00192-005-0006-5",
language = "English",
volume = "17",
pages = "335--339",
journal = "International Urogynecology Journal and Pelvic Floor Dysfunction",
issn = "0937-3462",
publisher = "Springer London",
number = "4",

}

TY - JOUR

T1 - Tension-free vaginal tape for the treatment of urodynamic stress incontinence with intrinsic sphincteric deficiency

AU - Ghezzi, Fabio

AU - Serati, Maurizio

AU - Cromi, Antonella

AU - Uccella, Stefano

AU - Salvatore, Stefano

AU - Triacca, Paola

AU - Bolis, Pierfrancesco

PY - 2006/8

Y1 - 2006/8

N2 - 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.

AB - 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.

KW - Intrinsic sphincteric deficiency

KW - Maximal urethral closure pressure

KW - Stress urinary incontinence

KW - TVT

KW - Valsalva leak point pressure

UR - http://www.scopus.com/inward/record.url?scp=33744805353&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33744805353&partnerID=8YFLogxK

U2 - 10.1007/s00192-005-0006-5

DO - 10.1007/s00192-005-0006-5

M3 - Article

C2 - 16211315

AN - SCOPUS:33744805353

VL - 17

SP - 335

EP - 339

JO - International Urogynecology Journal and Pelvic Floor Dysfunction

JF - International Urogynecology Journal and Pelvic Floor Dysfunction

SN - 0937-3462

IS - 4

ER -