Long-term subjective assessment of tension-free vaginal tape for recurrent stress urinary incontinence: A comparison with primary trans-obturator tape.

OBJECTIVES

Stress urinary incontinence (SUI) affects 10-20 % of the female population. The primary surgical treatment for women with SUI is mid-urethral sling surgery (MUS). No clear guidelines exist for second-line management in patients with recurrences. This study compared quality of life and the occurrence of urinary symptoms after a secondary retropubic tension-free vaginal tape (TVT) intervention in patients with failure of primary transobturator tape (TOT) surgery with those who had experienced successful primary TOT surgery.

METHODS

We conducted a retrospective cross-sectional study to compare efficacy and quality of life in patients who underwent the primary TOT procedure versus those who had a secondary TVT intervention after a failed TOT surgery. The Urinary Distress Inventory 6 (UDI-6) (questions 15-20 in the PFDI-20) was used to assess urinary symptoms.

RESULTS

Sixty-seven patients were enrolled in the study. Forty-five patients underwent successful primary TOT surgery (defined as no bothersome SUI symptoms post-surgery), while twenty-two underwent secondary TVT surgery for recurrent symptoms. Basic demographic characteristics were comparable in both groups. The median follow-up was 32 months for the successful primary TOT group and 25.5 months for the secondary TVT group (p = 0.33). There were no significant differences in UDI-6 scores (24.3 ± 25.3 for the successful primary TOT group versus 29.5 ± 27.2 for the secondary TVT group, p = 0.44). Rates of stress urinary incontinence, urgency urinary incontinence, and voiding dysfunction were also comparable between the groups. There were no surgical complications in the secondary TVT group.

CONCLUSION

Quality of life, as assessed by the UDI-6 inventory, and rates of urinary symptoms were similar in the secondary TVT and successful primary TOT groups. The secondary TVT procedure may present a favorable surgical option for treating recurrent SUI after failed primary TOT.