Q-tip test and tension-free vaginal tape in the management of female patients with genuine stress incontinence.

INTRODUCTION

To compare the Q-tip test before and after performance of the tension-free vaginal tape (TVT) procedure in women with genuine stress incontinence, and to determine the value of the Q-tip test in order to predict the outcome of TVT.

METHODS

Thirty-one patients with a diagnosis of stress incontinence but without previous anti-incontinence surgery (group I) and 10 patients with stress incontinence and a history of previous anti-incontinence surgery (group II) participated in the study. None of these patients had an anterior vaginal wall prolapse of greater than stage I according to the International Continence Society Classification and, therefore, the TVT procedure was the only operation performed on these patients. Urethral mobility using the Q-tip test was assessed by the same examiner at the initial physical examination and at the 6-month follow-up examination. Cure was defined as no leakage of urine postoperatively either subjectively or objectively, while failure was defined the objective loss of urine during the stress test.

RESULTS

The mean preoperative and postoperative Q-tip measurement in patients without previous operation (group I) was 43.5 +/- 5.84 and 33.38 +/- 4.77 degrees, respectively (mean difference 10.12 degrees), while the cure rate was 87.1%. The mean preoperative and postoperative Q-tip measurement in patients with previous operation (group II) was 17.5 +/- 4.44, and 11.1 +/- 6.88 degrees, respectively (mean difference 6.4 degrees), while the cure rate was 40%.

CONCLUSIONS

Adequate mobility of the proximal urethra is associated with a high success rate of the TVT procedure.