Q-Tip test and tension-free vaginal tape in the management of female patients with genuine stress incontinence

Introduction: To compare the Q-tip test before and after performance of the tension-free vaginal tape (TVT) procedure in women with genuine stress incontinence, and to determine the value of the Q-tip test in order to predict the outcome of TVT. Methods: Thirty-one patients with a diagnosis of stress incontinence but without previous anti-incontinence surgery (group 1) and 10 patients with stress incontinence and a history of previous anti-incontinence surgery (group 11) participated in the study. None of these patients had an anterior vaginal wall prolapse of greater than stage I according to the International Continence Society Classification and, therefore, the TVT procedure was the only operation performed on these patients. Urethral mobility using the Q-tip test was assessed by the same examiner at the initial physical examination and at the 6-month follow-up examination. Cure was defined as no leakage of urine postoperatively either subjectively or objectively, while failure was defined the objective loss of urine during the stress test. Results: The mean preoperative and postoperative Q-tip measurement in patients without previous operation (group 1) was 43.5 +/- 5.84 and 33.38 +/- 4.77degrees, respectively (mean difference 10.12degrees), while the cure rate was 87.1%. The mean preoperative and postoperative Q-tip measurement in patients with previous operation (group 11) was 17.5 +/- 4.44, and 11.1 +/- 6.88degrees, respectively (mean difference 6.4degrees), while the cure rate was 40%. Conclusions:Adequate mobility of the proximal urethra is associated with a high success rate of the TVT procedure. Copyright (C) 2002 S. Karger AG, Basel.