Long-term outcome of the retropubic TVT procedure for women with stress urinary incontinence: 20-25-year follow-up.

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.