Abstract
The aim of the study was to evaluate the safety and efficacy of TVT (tension-free vaginal tape) for the surgical treatment of stress urinary incontinence. The design was a prospective open multicenter study including six centers, each operating an approximately 20 patients. In total 131 patients suffering from genuine stress incontinence were included. They were followed for at least 1 year using a specific protocol for objective and subjective evaluation of the outcome. All patients underwent the operation under local anesthesia. Mean operation time was 28 minutes (range 19–41 minutes); 119 (91%) of the patients were cured according to the protocol and another 9 (7%) were significantly improved. There were 3 (2%) failures. The majority of the patients (about 90%) were operated upon on a day-care basis, which implied that they were released from the hospital within 24 hours, with no postoperative catheterization. No defect healing and no tape rejection occurred. Three patients needed an indwelling catheter for 3 days. In 1 patient catheterization was necessary for more than 10 days. Two uncomplicated hematomas and one uncomplicated bladder perforation occurred. Based on the results, we conclude that TVT is a safe and effective ambulatory procedure for surgical treatment of genuine stress urinary incontinence.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ulmsten U, Henriksson L, Johnson P, Varhos G. An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence.Int Urogynecol J 1996;7:81–86
Petros P, Ulmsen U. An integral theory of female urinary incontinence. Experimental and clinical considerations.Acta Obstet Gynecol Scand 1990;69(Suppl 153)
Petros P, Ulmsten U. An integral theory and its method for the diagnosis and management of female urinary incontinence.Scand J Urol Nephrol 1993:(Suppl 153)
Petros P, Ulmsten U. Urethral pressure increase on effort originates from within the urethra, and continence from muscilovaginal closure.Neurourol Urodyn 1995;14:337–350
Petros P, Ulmsten U. Role of the pelvic floor in bladder neck opening and closure: II vagina.Int Urogynecol J 1997;8:69–73
Petros P, Ulmsten U. Role of the pelvic floor in bladder neck opening and closure: I muscle forces.Int Urogynecol J 1997;8:74–80
US Department of Health and Human Services. Urinary incontinence in adults: acute and chronic management. Clinical Practice Guideline 1996;No 2:51–61
Ulmsten U, Asmussen M, Lindström K. A new technique for simultaneous urethrocystometry and measurement of the urethral pressure profile.Urol Int 1977;32:88–92
Khullar V, Salvatore S, Cardozo LD, Yip A, Kelleher CJ. The importance of urinary symptom and urodynamic parameters in quality of life assessment.Neurourol Urodyn 1995;14:540–542
Ingelman-Sundberg A, Ulmsten U. Surgical treatment of female urinary stress incontinence.Contrib Gynecol Obstet 1983;10:51–69
Nilsson C-G. IVS/TVT—a new surgical procedure for treatment of female stress urinary incontinence. Finnish and Scandinavian experiences. Nordic Urogynecological Association meeting, Oslo, 7–8 February 1997.Acta Obstet Gynecol (in press)
Ulmsten U, Hilton P, Ferrari A, Fischer W. Jacquetin B. Tension-free vaginal tape procedure. A micro-invasive surgical technique for GSI. 22nd Annual Meeting of the International Urogynecological Association, July 30–August 2 1997, Amsterdam, The Netherlands.Int Urogynecol J 1997;8: S 128
Ulmsten U, Petros P. Intravaginal slingplasty (IVS): an ambulatory surgical procedure for treatment of female urinary incontinence.Scand J Urol Nephrol 1995;29:75–82
Falconer C, Ekman-Ordeberg G, Malmström A, Ulmsten U. Clinical outcome and changes in connective tissue metabolism after intravaginal slingplasty in stress incontinent women.Int Urogynecol J 1996;7:133–137
Wang, AC, Lo TS. Tension-free vaginal tape. A minimally invasive solution to stress urinary incontinence in women.J Reprod Med 1993;43:(In press)
Villet R, Fitremann C, Salet-Lizee D, Collard D, Zafiropulo M. Un nouveau procédé de traîtement de l'incontinence urinaire d'effort (IUE): soutènement sous-urétral de prolène sous anesthésie locale.Progrès en Urologie 1998:8
Ulmsten U, Johnson P, Rezapour M. A 3-year follow-up of TVT. Submitted for publication 1998.
Author information
Authors and Affiliations
Additional information
Editorial Comment: This is the first prospective study of a relatively new and minimally invasive surgical procedure for stress urinary incontinence. The authors are to be complimented on the fact that they went out into the community hospitals in their area to see if their results could be reproduced by the average practicing gynecologist. Also, it is good to see that the investigators used a validated quality of life assessment to provide very important follow-up information on the improvement in the patient's quality of life, as this should be the basic tenet of all therapies for urinary incontinence. However, many questions remain regarding the diagnostic criteria they used in selecting their patients, as well as the degree of testing performed postoperatively. Further study is needed to confirm the results found here with a very new and interesting technique in the surgical treatment of stress incontinence.
Rights and permissions
About this article
Cite this article
Ulmsten, U., Falconer, C., Johnson, P. et al. A multicenter study of tension-free vaginal tape (TVT) for surgical treatment of stress urinary incontinence. Int Urogynecol J 9, 210–213 (1998). https://doi.org/10.1007/BF01901606
Issue Date:
DOI: https://doi.org/10.1007/BF01901606