Study objective: We evaluated effectiveness of tension-free vaginal tape application for surgical relief of intrinsic sphincter deficiency.
Design: A prospective study (Canadian Task Force classification II-3).
Setting: Tertiary center of medical faculty.
Patients: We studied 47 patients.
Interventions: Tension-free vaginal tape procedure, questionnaire form, stress test, cotton swab test, and functional bladder volume measurements.
Measurements and main results: Patients were grouped as intrinsic sphincter deficiency according to American College of Obstetricians and Gynecologists criteria. Operative results were documented at 6, 12, 36, and 60 months after the procedure by using a questionnaire form and objective tests of stress test, cotton swab test, and mean bladder functional volume measurement. At first visit 6 months after procedure, 70% (n = 35) of patients were completely satisfied, 9 (18%) had improved urine control, and 5 (10%) had no change in urine control. Results were: 72% (n = 36), 12% (n = 6), and 14 (n = 7%) at the end of the first year, and 66% (n = 33), 20% (n = 10), and 14% (n = 7) at the end of the third year, respectively. The fifth year's follow-up visit revealed 57.4% (n = 27 of 47) satisfaction, 17.02% (8 of 47) improved urine control, and 25.5% (12 of 47) no change in urine control.
Conclusion: Tension-free vaginal tape procedure is a safe and effective technique for patients who have exclusively intrinsic sphincter deficiency. Long-term results will clarify the value of this procedure in comparison with classic antistress surgical techniques.