Tension-free vaginal tape (TVT) for treatment of stress urinary incontinence in women with low-pressure urethra

Objective: To assess the results of TVT in patients with urinary stress incontinence, urethral hypermobility, and low-pressure urethra. Study design: We retrospectively analysed 265 consecutive women who underwent a TVT procedure for urodynamic stress urinary incontinence over a 31-month period. Women were divided into two groups depending on their preoperative maximum urethral closure pressure (MUCP). Group 1 (61 women with MUCP <= 20 cm H2O) were compared with 204 women (group 2) with a MUCP >20 cm H2O. Subjective and objective outcome data were assessed from routine postoperative visits. Office and hospital records were reviewed to check patients' characteristics, intraoperative findings, and surgical outcomes. Results: Women with low-pressure urethra were older than those with MUCP >20 cm H2O; they were more likely to have had a hysterectomy or anti-incontinence surgery. The mean duration of follow-up was 31 ( 11) months. Cure rates among patients with low- or normal-pressure urethra were similar (77% and 86%, P = 0.70). Nevertheless, the former were more likely to complain of voiding dysfunction. Conclusion: TVT is a highly effective treatment even in women with intrinsic sphincter deficiency. (c) 2005 Elsevier Ireland Ltd. All rights reserved.