Factors predictive of outcome in tension-free vaginal tape procedure for urinary stress incontinence in a teaching hospital.

INTRODUCTION

A study was performed to determine which patients' characteristics before tension-free vaginal tape (TVT) for stress incontinence are predictive of a failed outcome.

METHODS

A prospective cohort of 305 women with urinary stress incontinence underwent a TVT procedure in a teaching hospital. TVT was considered successful when the patient was fully satisfied and no leakage was seen at the standardized stress test. Logistic regression analysis examined the relationship between outcome and 32 pre-, intra-, and postoperative patient characteristics. All operations were done by trainees under supervision and assistance.

RESULTS AND CONCLUSIONS

Eighty one percent was successfully treated. Independent predictors of TVT failure were previous surgery for incontinence (P = 0.006), >2 pads/diapers per day before treatment (P = 0.012), chronic use of psychotropic medication (P = 0.012), and a more advanced age of the patient (P = 0.005). Postoperative urgency was independently related to preoperative urgency (P < 0.001). Independent predictors of postoperative dissatisfaction were urgency symptoms (P < 0.001) and the need for a re-intervention (P < 0.001).