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Long-term results with tension-free vaginal tape on mixed and stress urinary incontinence.
Uppsala University, Interfaculty Units, Centrum för klinisk forskning Dalarna.
Medicinska vetenskapsområdet, Faculty of Medicine, Department of Women's and Children's Health. Uppsala University, Interfaculty Units, Centrum för klinisk forskning Dalarna. (Obstetrisk forskning/Axelsson)
Medicinska vetenskapsområdet, Faculty of Medicine, Department of Women's and Children's Health. Department of Comparative Medicine. (Obstetrisk forskning/Axelsson)
2005 (English)In: Obstet Gynecol, ISSN 0029-7844, Vol. 106, no 1, 38-43 p.Article in journal (Refereed) Published
Place, publisher, year, edition, pages
2005. Vol. 106, no 1, 38-43 p.
Keyword [en]
Aged, Female, Follow-Up Studies, Humans, Logistic Models, Middle Aged, Multivariate Analysis, Patient Satisfaction, Probability, Questionnaires, Risk Assessment, Severity of Illness Index, Surgical Mesh, Time Factors, Treatment Outcome, Urinary Incontinence/etiology/pathology/surgery, Urinary Incontinence; Stress/etiology/pathology/*surgery, Urodynamics, Urologic Surgical Procedures/*methods, Uterine Prolapse/diagnosis/*surgery
Identifiers
URN: urn:nbn:se:uu:diva-75751PubMedID: 15994615OAI: oai:DiVA.org:uu-75751DiVA: diva2:103662
Available from: 2006-08-09 Created: 2006-08-09 Last updated: 2011-01-11
In thesis
1. Tension-free Vaginal Tape at a Medium Sized Hospital in Sweden: Short- and Long-term Results in Different Patient Groups
Open this publication in new window or tab >>Tension-free Vaginal Tape at a Medium Sized Hospital in Sweden: Short- and Long-term Results in Different Patient Groups
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In the years 1995 to 2001, 970 women with urinary incontinence underwent surgery with tension-free vaginal tape (TVT) at the Department of Obstetrics and Gynecology, Falun Hospital. In 2002 the charts of all these women were reviewed and a questionnaire was sent in 2004. 760 women (78,4%) answered the questions. The mean time since surgery was 5.7 years. The mean age at surgery was 58.7 years. Of all patients, 580 had pure stress urinary incontinence (SUI) and 112 had mixed urinary incontinence (MUI) prior to surgery. Of the women with SUI, 85 % were subjectively and persistently cured. Of the women with MUI, 60 % were subjectively cured up to 3 years after the TVT operation.  However this figure declined to 30 % among women operated on 6-8 years previously. The increasing incontinence was due to urgency symptoms and urge urinary incontinence (UUI).The IIQ-7 and UDI-6 questionnaires were used for measuring quality of life. The women showed dramatic improvement after TVT surgery irrespective of time since surgery. Women with chronic diseases also had relative improvement in QOL scores. Sixty-seven of the women with pure SUI preoperatively (14.5%) reported persistent de novo urgency symptoms postoperatively and 51 of the women also had UUI. Old age, history of cesarean section, increasing parity and BMI were risk factors for developing de novo urgency after TVT procedure. Among women ≥ 75 years 55.7% reported cure after TVT, compared to 79.7% of women < 60 years. The overall cure rate in the very overweight women (BMI ≥ 35) was 52.1%, compared to 81.2% in women of normal weight (BMI < 25).

Conclusions. The subjective results after TVT surgery for SUI are very good even after 8 years. Short-term effect of TVT on MUI is acceptable, but declines after 3 years. Improvements in measures of quality of life after TVT surgery are dramatic and persistent in both the SUI and MUI groups. Women who developed de novo urgency symptoms after TVT surgery reported poorer quality of life. The TVT procedure is simple and safe, but the results in the oldest or most overweight women are not as good as in the younger or normal weight women.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2010. 59 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 547
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
urn:nbn:se:uu:diva-121550 (URN)978-91-554-7766-0 (ISBN)
Public defence
2010-06-08, Rosénsalen, Akademiska sjukhuset, Ing 96, Kvinnokliniken, Uppsala, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2010-04-26 Created: 2010-03-25 Last updated: 2010-04-26Bibliographically approved

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Nilsson, Staffan

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Centrum för klinisk forskning DalarnaDepartment of Women's and Children's HealthDepartment of Comparative Medicine

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