Glavind Karin, Glavind Emilie
Department of Gynecology and Obstetrics, Aalborg Sygehus, Denmark.
Acta Obstet Gynecol Scand. 2007;86(3):357-60. doi: 10.1080/00016340601124227.
No consensus on the proper treatment of prolonged voiding dysfunction after incontinence operations exists. We, therefore, evaluated the treatment of this problem.
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.
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.
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.
