The Effect of Tension-Free Vaginal Tape Surgery on Mixed Urinary Incontinence Symptoms and Anatomical Parameters: The Role of Transperineal Ultrasonography in Follow-Up

Objective: Tension-free vaginal tape (TVT) in patients with mixed urinary incontinence (MUI) operation was aimed to show the changes in stress and urge incontinence symptoms and quality of life.Materials and Methods: This prospective study included 36 patients with MUI who underwent TVT operation. Bladder neck descent, retrovesical angle, pubourethral distance, urethral thickness, detrusor thickness, bladder, rectum, and uterus descent, and urethral rotation angle were evaluated preoperatively and 2 years postoperatively by transperineal ultrasonography, and Pelvic Organ Prolapse Quantification staging was performed. Preoperative and postoperative international consultation on incontinence questionnaire short form (ICIQ-SF) and overactive bladder questionnaire (OAB-V8) questionnaires were also performed.Results: The mean ICIQ-SF questionnaire score decreased from 16.39 preoperatively to 5.28 postoperatively. Urge symptoms assessed by the OAB-V8 questionnaire improved compared with the preoperative period (mean scores were 29.22 and 9, respectively). Nocturia mean score decreased from 2.31 to 0.81, while nocturnal voiding rates improved significantly (mean scores were 3.39 and 1.14, respectively). It was statistically proven that the effects of urinary incontinence on overall quality of life decreased after TVT (mean scores were 7.72 and 2.57, respectively). Furthermore, the mean score of bladder neck descent was 33.27 +/- 3.90 preoperatively and 17.19 +/- 3.91 postoperatively; the mean score of pubourethral distance was 12.11 +/- 1.95 preoperatively and 7.83 +/- 1.32 postoperatively; the mean score of urethral thickness was 8.69 +/- 1.58 preoperatively and 5.08 +/- 1.05 postoperatively; the mean score of detrusor thickness was 7.28 +/- 1.52 preoperatively and 4.92 +/- 1.02 postoperatively. A statistically significant difference was found between the mean scores of these parameters. In addition, retrovesical angle and urethral rotation angles decreased below the cut-off value postoperatively.Conclusions: In patients who underwent TVT for stress incontinence, if voiding functions can be restored to near normal, urge and stress symptoms improve.