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
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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 -