Long-Term Subjective Efficacy of Female Stress Urinary Incontinence with Tension-Free Vaginal Tape-Obturator Technique

Introduction and hypothesis: The objective was to evaluate the long-term subjective efficacy of the tension-free vaginal tape-obturator (TVT-O) technique in the treatment of female stress urinary incontinence (SUI).

Methods: A retrospective analysis was performed on 84 patients who underwent TVT-O surgery for SUI in a tertiary center between January 2007 and December 2013. All patients filled in the Urinary Incontinence Quality of Life Questionnaire (I-QOL), the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form (PISQ-12). Subjective efficacy, including surgical efficacy, clinical severity of SUI, improvement in quality of life (QoL), and sexual activity with regard to TVT-O were compared before and after surgery (≥ 10 years).

Results: The average postoperative follow-up time was 12.6 ± 1.9 years, range, 10-16 years. The overall subjective effectiveness of the surgery was 94.0% (79 out of 84). The subjective clinical severity significantly improved more than 10 years after surgery compared with the preoperative value (p = 0.000). The median I-QOL score was 88.1 (84.1-92.0) preoperatively and 98.3 (94.3-99.7) postoperatively, and the long-term QoL of postoperative patients was significantly improved (p < 0.05). The median ICIQ-SF score was 10.5 (8-15) preoperatively, and 3 (0-5) postoperatively, and the ICIQ-SF score before and after surgery showed significant improvement in urinary incontinence symptoms (p < 0.05). No difference was observed in the PISQ-12 scores before and after surgery in the sexually active population.

Conclusions: The TVT-O technique still has good subjective efficacy in SUI more than 10 years after surgery and significantly improves the QoL of patients.