Treatment of Voiding Dysfunction Following Tension Free Vaginal Tape Procedure for the Patient of Stress Urinary Incontinence.
- Author:
Seong Ho LEE
1
;
Hee Chang JUNG
Author Information
1. Department of Urology, College of Medicine, Yeungnam University, Daegu, Korea. junghc@med.yu.ac.kr
- Publication Type:Original Article
- Keywords:
Urinary stress incontinence;
Dysfunction;
Treatment
- MeSH:
Cholinergic Antagonists;
Humans;
Intermittent Urethral Catheterization;
Suburethral Slings*;
Urinary Incontinence*;
Urinary Incontinence, Stress
- From:Korean Journal of Urology
2003;44(9):901-906
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The aims of this study were to analyze the types of voiding dysfunction following a tension free vaginal tape (TVT) procedure, and to report our experience of diagnosing and treating post-TVT voiding dysfunction. MATERIALS AND METHODS: A TVT procedure was performed on 201 patients, of which, 51 (25.4%) developed a voiding dysfunction. The TVT was incised or released to increase the uroflow and decrease the residual urine volume for those whose symptoms were not controlled by anticholinergics (tolterodine, propiverine) and/or alpha-blockers (alfuzocin, terazocin) or clean intermittent catheterization (CIC). The success rate and degree of satisfaction were investigated for the correction of stress incontinence. RESULTS: In 36 patients, the voiding symptoms improved after medication administration, with a mean interval of 16.5 days. Another 15 patients required a TVT incision or release at means of 27 and 8 days, respectively. After the incision or release of the TVT sling, the mean maximal flow rate (MFR) increased from 9.3+/-4.3 to 21.7+/-6.7ml/sec, and mean residual urine volume (RU) decreased from 277.9+/-156.2 to 24.6+/-16.0ml. The success rate and satisfaction of the TVT procedure were 98.0 and 90.4%, respectively. Lastly, 88.3% of the subjects reported they would recommend the TVT procedure to people they know with symptoms of stress urinary incontinence. CONCLUSIONS: This study suggests that voiding dysfunction, with normal uroflow and RU, may be effectively controlled with conservative treatment. However, when the voiding dysfunction is accompanied by a decreased MFR and an increased RU, an additional procedure, such as the TVT incision or release, is recommended.
