The Long Term (5-Years) Objective TVT Success Rate Does Not Depend on Predictive Factors at Multivariate Analysis

Autor: Jiyoon Kim, Kyu-Sung Lee, Deok-Hyun Han, Chin Kyung Doo, Wan Suk Kim, Hee Chang Jung, Myung-Soo Choo, Young-Suk Lee
Rok vydání: 2008
Předmět:
Zdroj: European Urology. 53:176-183
ISSN: 0302-2838
DOI: 10.1016/j.eururo.2007.08.033
Popis: Objectives We evaluated the predictive risk factors that could affect the long-term efficacy of the tension-free vaginal tape (TVT) procedure for the treatment of female stress urinary incontinence (SUI). Methods One hundred thirty-eight (mean age, 52.4±9.3 yr) women who underwent the TVT procedure for SUI were selected and followed up for at least 5 yr (mean, 67.2 mo; range, 60–76) after the surgery. We analyzed the preoperative and intraoperative parameters using univariate and multivariate regression for cure rates and patients' satisfaction. Results The overall 5-yr cure rate was 76.8%, with a satisfaction rate of 86.9%. The cure rates were lower in patients with high body mass index (BMI≥25kg/m 2 /BMI 2 =68.3%:83.3%, p =0.044), low abdominal leak point pressure (ALPP 2 O/ALPP≥60cm H 2 O=51.6%:82.8%, p =0.003), and high grade of SUI (40.0% in grade III; 69.7% in grade II; 86.6% in grade I, p =0.012). On multivariate analysis, there were no independent risk factors related to cure rate, and urgency was the only factor independently associated with patients' satisfaction ( p =0.017; odds ratio=4.114). Conclusions This study demonstrates that the TVT procedure is effective for female SUI without any independent predictive factors affecting long-term cure rate. Urgency was the only predictive factor affecting patient satisfaction. However, high BMI, low ALPP, and high grade of incontinence may impair the cure rate of the TVT.
Databáze: OpenAIRE