uu.seUppsala University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
The very obese woman and the very old woman: Tension-free vaginal tape for the treatment of stress urinary incontinence
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Center for Clinical Research Dalarna. (Obstetrisk forskning/Axelsson)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Center for Clinical Research Dalarna. (Obstetrisk forskning/Axelsson)
2007 (English)In: International Urogynecology Journal, ISSN 0937-3462, E-ISSN 1433-3023, Vol. 18, no 4, 423-429 p.Article in journal (Refereed) Published
Abstract [en]

A mailed questionnaire was sent to 970 consecutive women who underwent a tension-free vaginal tape (TVT) procedure between 1995 and 2001 at the Department of Obstetrics and Gynecology in Falun Hospital. Seven hundred and sixty (78.4%) women responded. The outcome was compared between women older than 75 years (n=113) and younger women, and between women with a body mass index (BMI) above 35 (n=61) and those who had normal weight. Mean follow-up was 5.7 years. Thirty-six elderly women and one of the obese women were deceased at the long-term follow-up. TVT was easy to perform and was a safe procedure for women in all groups. There was a sharp decrease in cure rate of any urinary incontinence problems among women aged 75 years or more (55.7%), as compared to those who were younger (79.7%). The cure rate moderately decreased from BMI groups 19–24 to 30–34. BMI ≥35 seemed to be the best explanatory cutoff level. The overall cure rate in women of normal weight was 81.2%, as compared to 52.1% in the very obese. The cure rate for urinary incontinence with tension-free vaginal tape in women above 75 years of age and in women with a BMI above 35 was acceptable, but lower as compared to the remaining study population.

Place, publisher, year, edition, pages
2007. Vol. 18, no 4, 423-429 p.
Keyword [en]
Urinary incontinence, Tension-free vaginal tape, Obesity, Aged
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-10385DOI: 10.1007/s00192-006-0162-2ISI: 000244724400011PubMedID: 16868657OAI: oai:DiVA.org:uu-10385DiVA: diva2:38153
Available from: 2007-03-21 Created: 2007-03-21 Last updated: 2017-12-11Bibliographically approved
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

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Authority records BETA

Nilsson, Staffan

Search in DiVA

By author/editor
Nilsson, Staffan
By organisation
Department of Women's and Children's HealthCenter for Clinical Research Dalarna
In the same journal
International Urogynecology Journal
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 421 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf