Tension-Free Vaginal Tape for the Treatment of Stress Urinary Incontinence: A 13-Year Prospective Follow-Up.

STUDY OBJECTIVE

To evaluate the long-term safety and efficacy of tension-free vaginal tape (TVT).

DESIGN

Prospective observational study (Canadian Task Force classification II-2).

SETTING

Tertiary referral center in China.

PATIENTS

Between January 2004 and December 2005, 85 consecutive patients who underwent the TVT procedure were included. Patients with mixed incontinence or pelvic organ prolapse requiring surgery were excluded.

INTERVENTIONS

TVT procedure.

MEASUREMENTS AND MAIN RESULTS

The primary outcomes were long-term postoperative complications. The secondary outcomes included long-term subjective satisfaction (Patient Global Impression of Improvement), objective cure rate (stress test), quality of life, and sexual function. At the 13-year follow-up, 70 patients (82%) were available for evaluation. De novo overactive bladder was observed in 15.7% of patients, and voiding symptoms were found in 17.1% of patients. None of the patients reported voiding dysfunction that needed treatment with tape removal or catheterization. Tape exposure occurred in 2.9% of patients. The subjective satisfaction rate and objective cure rate were 78.6% and 81.4%, respectively.

CONCLUSION

TVT is a safe and effective treatment for stress urinary incontinence, even at the 13-year follow-up. The prevalence rates of overactive bladder and voiding symptoms are increased with advancing age and should not be considered long-term postoperative complications.