European journal of obstetrics, gynecology, and reproductive biology · 2025
Long-term outcome of the retropubic TVT procedure for women with stress urinary incontinence: 20-25-year follow-up.
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Lebar Vojka, Lukanović Adolf, Matjašič Miha, Barbič Matija, Lukanović David
Аннотация
INTRODUCTION: Stress urinary incontinence (SUI) significantly affects women's quality of life. The tension-free vaginal tape (TVT) procedure has demonstrated short- and medium-term efficacy, but data beyond 15 years remain scarce. This study evaluates the 20- to 25-year outcomes of the retropubic TVT procedure in terms of efficacy, safety, and patient satisfaction.
METHODS: This retrospective cohort study included 135 women that underwent the retropubic TVT procedure between 1998 and 2003. All surgeries were performed by two surgeons using the Gynecare TVT™ Sling. Data were obtained from medical records, follow-ups, and telephone interviews (January-March 2024). Outcomes were assessed using the Patient Global Impression of Improvement (PGI-I), International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), and Urinary Distress Inventory-Short Form (UDI-6).
RESULTS: Out of 593 women originally treated, 135 completed long-term follow-up. The mean age at surgery was 50.3 years and 72.5 years at follow-up. The median PGI-I score of 2.0 indicated that 76.3 % of patients reported significant improvement. The median ICIQ-SF score was 7.0, reflecting moderate symptom burden, and the median UDI-6 score was 22.2, with 20 % of patients reporting significant urgency symptoms. Postoperative complications were low; 85.9 % of patients had no complications, 13.3 % experienced urinary retention, and 0.7 % had tape erosion. Repeat TVT was required in 9.6 % of cases, with significantly lower satisfaction (p = 0.002). PGI-I scores strongly correlated with ICIQ-SF (r = 0.801, p < 0.01) and UDI-6 (r = 0.676, p < 0.01).
CONCLUSIONS: TVT remains an effective long-term SUI treatment with high satisfaction and low complications. Long-term follow-up is essential for monitoring late-onset complications.
METHODS: This retrospective cohort study included 135 women that underwent the retropubic TVT procedure between 1998 and 2003. All surgeries were performed by two surgeons using the Gynecare TVT™ Sling. Data were obtained from medical records, follow-ups, and telephone interviews (January-March 2024). Outcomes were assessed using the Patient Global Impression of Improvement (PGI-I), International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), and Urinary Distress Inventory-Short Form (UDI-6).
RESULTS: Out of 593 women originally treated, 135 completed long-term follow-up. The mean age at surgery was 50.3 years and 72.5 years at follow-up. The median PGI-I score of 2.0 indicated that 76.3 % of patients reported significant improvement. The median ICIQ-SF score was 7.0, reflecting moderate symptom burden, and the median UDI-6 score was 22.2, with 20 % of patients reporting significant urgency symptoms. Postoperative complications were low; 85.9 % of patients had no complications, 13.3 % experienced urinary retention, and 0.7 % had tape erosion. Repeat TVT was required in 9.6 % of cases, with significantly lower satisfaction (p = 0.002). PGI-I scores strongly correlated with ICIQ-SF (r = 0.801, p < 0.01) and UDI-6 (r = 0.676, p < 0.01).
CONCLUSIONS: TVT remains an effective long-term SUI treatment with high satisfaction and low complications. Long-term follow-up is essential for monitoring late-onset complications.