[Complications and medium-term functional results of TVT in stress urinary incontinence].

INTRODUCTION

The TVT technique has transformed the surgical management of stress urinary incontinence. The published results are excellent and appear to be maintained in the long term. We decided to obtain the patients' opinion by postal questionnaire.

MATERIAL AND METHODS

235 women with stress urinary incontinence, 79 of whom were simultaneously operated for genital prolapse, were treated by suburethral TVT between November 1998 and December 2000. We studied the complications and sent a questionnaire based on the Ditrovie scale and the urinary disability scale to each patient.

RESULTS

Thirty one operative complications were reported (13.2%) with 26 bladder perforations (11%), 4 haemorrhages (1.7%) not requiring transfusion and 1 gastrointestinal injury (0.4%). 89.8% of patients reported cure of their incontinence at the postoperative visit. 159 patients completed the questionnaire (67.6%). The answers showed that, with a mean follow-up of 18 months, only 75.4% of women were completely dry. Women with sphincter incompetence or simultaneously treated for genital prolapse obtained similar results (84.2% and 73.2%). Only patients with recurrence of SUI obtained poorer results (71.4%). De novo urgency appeared to be rare, while pre-existing urgency resolved after the operation in 50% of cases. More than 80% of women reported a good or excellent quality of life, but 30% experienced pain that impaired quality of life.

CONCLUSION

TVT is an effective technique for the treatment of stress urinary incontinence. Answers to a postal questionnaire provide a more realistic view of the functional results, revealing incomplete results and pain for some women, which justify further studies based on validated questionnaires.