Can pre-operative urodynamic study predict the successful outcome of tension free vaginal tape (TVT) operation in Thai women with stress urinary incontinence?

ABSTRACT

OBJECTIVE: To study the preoperative urodryramic parameters whether it can predict the outcome of TVT operation in Thai women with stress urinary incontinence (SUI). STUDY DESIGN: Cohort study. MATERIAL AND METHOD: Twenty five Thai women undergone TVT from January to December 2004 at Bumrungrad Hospital were included in the present study. Urodyramic studies were done pre-operatively. The TVT operations were carried out with spinal anesthesia. The follow-ups at one, three, and six months were scheduled. RESULTS: At six months after the operation, the subjective cure rate was 72% (18/25) and 28% (7/25) had the improved symptoms. Multivariate regression analysis showed the valsava leak point pressure (VLPP) of less than 60 cm H2O to be associated with the 0.6-fold (0.3-0.9) risk of having successful outcome (being cured). Anyhow 7 cases of women not being cured still had improved symptoms and were satisfied with the operation. CONCLUSION: The present results confirmed the usefulness of pre-operative urodynamic study in prediction of the outcome of TVT. Low VLPP (<60 cm. H2O) was associated with poorer outcome of TVT operation in Thai women.