Department of Urogynaecology, National Maternity Hospital, Dublin 2, Ireland.
Royal College of Surgeons in Ireland, National Maternity Hospital, Dublin 2, Ireland.
BJOG. 2023 Jan;130(1):107-113. doi: 10.1111/1471-0528.17282. Epub 2022 Sep 11.
Long-term data regarding risks associated with tension-free vaginal tapes (TVT) are sparse, and where available are limited to small numbers. We analyse patient-reported outcomes of TVT after 16-24 years.
Prospective observational study.
Single-centre study in a tertiary referral urogynaecology unit.
A cohort of 350 women who had a TVT inserted between 1999 and 2004, in which 96% had urodynamically proven stress incontinence.
Postal questionnaire survey using the International Consultation on Incontinence Questionnaire, a visual analogue scale and a yes/no question as to whether they would have the procedure again.
The primary outcome was cure of stress urinary incontinence, which was assessed using the ICIQ-FLUTS questionnaire. Secondary outcomes included overactive bladder symptoms, pain, sexual dysfunction, and patient satisfaction with the procedure.
A total of 183/350 (52%) responses were received. The median age of women at follow up was 67 years (range 53-93 years) and the median follow up was 20 years (17-24 years). Stress urinary incontinence was denied by 39.3% of women. Urgency was reported by 42.1%. Bladder pain was reported either 'never' or 'occasionally' by 92.3% of women. The median satisfaction rate was 98/100 and 92.4% said they would have the TVT procedure again.
Tension-free vaginal tape has high levels of satisfaction and cure up to 24 years after placement. Pain was uncommon and its impact on quality of life was low. Symptoms of urgency were prevalent but may be related to age. TVT is an effective treatment for SUI more than 20 years after initial placement.
关于阴道无张力吊带（TVT）相关风险的长期数据很少，而且现有的数据也仅限于少数病例。我们分析了 TVT 术后 16-24 年的患者报告结局。
前瞻性观察性研究。
在一家三级转诊泌尿科单位进行的单中心研究。
350 名女性队列，她们在 1999 年至 2004 年间接受了 TVT 插入术，其中 96%的人有尿动力学证实的压力性尿失禁。
使用国际尿失禁咨询问卷（ICIQ）、视觉模拟量表和是否会再次接受该手术的是/否问题对患者进行邮寄问卷调查。
主要结局是压力性尿失禁的治愈，通过 ICIQ-FLUTS 问卷评估。次要结局包括膀胱过度活动症症状、疼痛、性功能障碍和患者对手术的满意度。
共收到 350 名女性中的 183 名（52%）的回复。随访时女性的中位年龄为 67 岁（范围 53-93 岁），中位随访时间为 20 年（17-24 年）。39.3%的女性否认存在压力性尿失禁，42.1%的女性报告有急迫感。92.3%的女性报告膀胱疼痛要么“从未有过”，要么“偶尔有过”。中位满意度评分 98/100，92.4%的女性表示会再次接受 TVT 手术。
TVT 术后 24 年内具有较高的满意度和治愈率。疼痛不常见，对生活质量的影响较低。急迫症状普遍存在，但可能与年龄有关。TVT 是一种有效的治疗压力性尿失禁的方法，在初次放置后 20 多年仍有效。
