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Journal of Peking University (Health Sciences) ›› 2024, Vol. 56 ›› Issue (4): 600-604. doi: 10.19723/j.issn.1671-167X.2024.04.009

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Medium to long-term efficacy of tension-free vaginal tape procedure in the treatment of female recurrent stress urinary incontinence

Yuqing LI,Biao WANG,Peng QIAO,Wei WANG*(),Xing GUAN*()   

  1. Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
  • Received:2024-03-21 Online:2024-08-18 Published:2024-07-23
  • Contact: Wei WANG,Xing GUAN E-mail:weiwang0920@163.com;gxuro@ccmu.edu.cn
  • Supported by:
    National Natural Science Foundation of China(82070764);National Natural Science Foundation of China(82370752);Beijing Natural Science Foundation(7234372)

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Abstract:

Objective: To investigate the effectiveness and clinical efficacy of tension-free vaginal tape (TVT) surgery in treating female recurrent stress urinary incontinence (rSUI). Methods: A retrospective analysis was conducted on 24 patients who experienced recurrence of mid-urethral sling failure and were treated with TVT surgery at Beijing Chao-Yang Hospital from January 2016 to June 2020. Basic patient information was collected. The International Consultation on Incontinence questionnaire-short form (ICI-Q-SF) was used to record urinary incontinence symptom scores preoperatively, 1-year postoperatively, and more than three years postoperatively. The changes in various ICI-Q-SF scores and total scores were compared. Additionally, clinical symptom severity of urinary incontinence was recorded and compared preoperatively and more than three years postoperatively. Results: Among the 24 patients included in the follow-up, one patient was lost to follow-up due to death from a cerebrovascular accident one year postoperatively, leaving 23 patients with a follow-up period ranging from 3.9 to 7.3 years, with an ave-rage follow-up time of (5.2±1.1) years. Preoperatively, the median ICI-Q-SF total score was 20.0 (16.0, 21.0); at the 1-year follow-up, the median ICI-Q-SF total score was 5.0 (1.5, 7.8) (P < 0.001); at an average follow-up of five years, the median ICI-Q-SF total score was 6.0 (3.0, 9.0), still showing a statistically significant difference compared with preoperative scores (P < 0.001). The individual ICI-Q-SF scores were significantly lower at the 1-year and average five-year follow-ups compared with preoperative scores (P < 0.001). Regarding the severity of urinary incontinence, all the patients had moderate to severe urinary incontinence preoperatively; Five years postoperatively, 87.0% (20/23) of the patients had no or only mild urinary incontinence, and 13.0% (3/23) had recurrent moderate to severe urinary incontinence (P < 0.001). Conclusion: TVT surgery is effective in treating female recurrent stress urinary incontinence, with an average 5-year cure and improvement rate of 87.0%.

Key words: Stress urinary incontinence, Female, Recurrence, Suburethral slings

CLC Number: 

  • R694.54

Table 1

Comparison of ICI-Q-SF subscale scores and total scores before and after surgery"

Items Preoperation 1 year postoperation Average 5 years postoperation
Frequency of leakage 4.5 (4, 5) 1.0 (1.0, 2.0)* 1 (1, 2)*
Amount of leakage 6 (4, 6) 2.0 (0.5, 2.0)* 2 (2, 2)*
Overall impact of urinary incontinence 10 (8, 10) 2.0 (0.3, 3.0)* 2 (1, 4)*
Total ICI-Q-SF score 20 (16, 21) 5.0 (1.5, 7.8)* 6 (3, 9)*

Table 2

Clinical symptom severity grading of patients with SUI before and after surgery"

Severity of clinical symptoms of SUI Preoperative Average 5 years postoperative
Never 0 11 (47.8)
Mild 0 9 (39.1)
Moderate 21 (87.5) 2 (8.7)
Sever 3 (12.5) 1 (4.3)
P* < 0.001 < 0.001
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