Treatment of prolonged voiding dysfunction after tension-free vaginal tape procedure.

BACKGROUND

No consensus on the proper treatment of prolonged voiding dysfunction after incontinence operations exists. We, therefore, evaluated the treatment of this problem.

METHODS

We reviewed all 143 patients who underwent a tension-free vaginal tape procedure (TVT) between April 1998 and June 2005. Prolonged voiding dysfunction was defined as the need to perform intermittent catheterisation for more than 1-2 weeks, and a subjective feeling of incomplete emptying.

RESULTS

Ten patients (7%) with prolonged voiding difficulties were encountered. In 5 patients (50%) the tape was pulled down. This was performed after 1 week (1 patient), 2 weeks (2 patients) and 3 weeks (2 patients). All these patients were cured of their voiding dysfunction and remained dry. In 2 patients, the tape was cut after 5 and 7 months. Both patients were cured of their voiding difficulties, but had recurrent stress incontinence. Three patients performed clean intermittent catheterisation for a period of 5 weeks, 7 months and 9 months, and some degree of prolonged voiding and/or urgency persisted in all three patients.

CONCLUSION

The patients with voiding difficulties after TVT should be followed closely for the first 1-2 weeks, and pulling the tape down should be carried out if the voiding dysfunction persists.