Quality of life after tension-free vaginal tape surgery for female stress incontinence

Objective. To undertake a long- term follow- up evaluation of the quality of life ( QOL) of women who had undergone a tension- free vaginal tape ( TVT) procedure. Material and methods. During the period 1995 - 2001, 970 women with urinary stress incontinence underwent TVT surgery at the Department of Obstetrics and Gynecology, Falun Hospital. A questionnaire was mailed on average 5.7 years after the TVT procedure. Two incontinence- specific QOL instruments- the Incontinence Impact Questionnaire- 7 ( IIQ- 7) and the Urogenital Distress Inventory- 6 ( UDI- 6)- were administered. An additional questionnaire included general questions and questions about chronic diseases that may be associated with urinary incontinence. Results. The mean age at surgery was 58.7 years ( range 29 - 89 years). Of 913 eligible women, 768 ( 78.9%) responded. Mean IIQ- 7 and IDU- 6 scores as estimated by the women improved dramatically at follow- up as compared to preoperative values: from 43.7 to 11.5 for the IIQ- 7 and from 54.2 to 24.0 for the UDI- 6 on a scale from 0 to 100 ( p = 0.0001 for both). There were few differences in mean QOL scores even 8 years after TVT surgery, compared to those determined a shorter time after the operation. Women with diabetes, chronic constipation, chronic bronchitis and preoperative recurrent urinary infections had a relative improvement in QOL of the same magnitude as that of the remaining study population. Advanced age was negatively associated with an improvement in QOL scores. Conclusions. Improvements in measures of QOL after TVT surgery are dramatic and persist for years. Women with concomitant diseases that may be associated with urinary incontinence can be assured that there is a good chance of success with TVT surgery.