Long-term Clinical Outcomes of the Tension-free Vaginal Tape Procedure for the Treatment of Stress Urinary Incontinence in Elderly Women over 65

Purpose: The aim of this study was to assess the long-term clinical outcomes of the tension-free vaginal tape (TVT) procedure for stress urinary incontinence (SUI) in elderly women and to identify the factors influencing failure in these cases. Materials and Methods: Women with SUI who underwent a TVT procedure were studied. "Cure" was defined as no urine leakage at all in any circumstances and "improvement" was defined as some urine leakage but a score of over 4 points out of 5 in a satisfaction inquiry. Patients were divided into two groups (middle-aged, <65 years and elderly, >= 65 years) for comparison of clinical outcomes. In the elderly group, patients were subdivided into two groups (cure and no cure groups) and were compared to identify the factors influencing failure. Results: A total of 136 women (middle-aged group, 106; elderly group, 30) were enrolled in the study. The mean ages of the patients in the 2 groups were 53.5 +/- 5.9 and 72.0 +/- 5.0 years and the mean follow-up times were 50.5 +/- 9.4 and 48.8 +/- 9.1 months, respectively. The cure and improvement rates in the middle-aged and elderly groups were 80.2% vs. 66.7% and 4.7% vs. 3.3%, respectively (p>0.05). The satisfaction scores in the middle-aged and elderly groups were 3.8 +/- 1.1 vs. 3.3 +/- 1.5 points (p>0.05). In the elderly group, the body mass index of the cure and no cure groups were 24.6 +/- 3.3 kg/m(2) and 26.6 +/- 1.0 kg/m(2), and body mass index was the only factor that differed significantly between the two subgroups (p=0.028). Conclusions: Our long-term results suggest that TVT is an effective treatment even in elderly women. However, elderly women who are obese should be counseled carefully about the success rate.