Assessment of the long-term outcome of TVT procedure for stress urinary incontinence in a female population: results at 17 years' follow-up.

INTRODUCTION AND HYPOTHESIS: To assess the outcome of the tension-free vaginal tape (TVT) procedure in female patients with urodynamic stress urinary incontinence at 17 years follow-up.

METHODS: We carried out a prospective study at the 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, University of Athens, Greece. Patients who had undergone a TVT procedure 17 years ago. The follow-up assessment included gynecological examination, urinalysis, cough stress test in the lithotomy and/or upright position, filling and voiding cystometry, and uroflow. Also, all patients were required to complete the Patient Satisfaction Questionnaire (PSQ).

RESULTS: Out of the 61 initial patients, 56 were available for follow-up. Objective cure rate was 83.9% (47/56) at 17 years follow-up. Subjective cure rate was 78.6% (44/56), subjective improvement was 8.9%, and failure rate was 12.5%. Frequency was present in 39.3% of patients, overactive bladder symptoms were present in 30.3% of patients and urge urinary incontinence was reported by 12.5% of patients. Difficulty emptying the bladder was reported by 10 patients (17.8%) and recurrent urinary tract infection was seen in 3.5% of patients. There was one case of TVT erosion to the vaginal mucosa, which was managed conservatively.

CONCLUSIONS: The TVT procedure for the management of stress urinary incontinence in women maintains its efficacy in the long term, having an objective cure rate of 83.9% and a subjective cure rate of 78.6% at 17 years' follow-up, with a very low complications rate.