The Effect of Tape-tension Change on Outcome of Tension-free Vaginal Tape Procedure and Voiding Function

ABSTRACT

PURPOSE: The aim of this study was to investigate the effect of tape-tension on outcome of tension-free vaginal tape(TVT) procedure and voiding function. MATERIALS AND METHODS: We included 62 women patients with stress urinary incontinence. The patients were randomized into two groups and underwent the TVT procedure according to the standard method with some modifications. In group I(n=28), the position of the tape was adjusted with no tension by placing Mayo scissors between the tape and urethra and in group II(n=34), the tape was placed in the same fashion except that create 5mm-long tape loop under urethra for more loosening the tape-tension than that of group I. The success rate of TVT, the rate of postoperative voiding dysfunction and pre- and postoperative quality of life(QOL), peak urinary flow rate(Qmax), post-void residual(PVR) were compared between the two groups. RESULTS: There were no significant differences in success rate and improvement of QOL between the groups. In group I, Qmax was significantly decreased and the PVR was significantly increased after TVT compared with group II. The voiding dysfunction after TVT occurred in 3(10.7%) and 1(2.9%) in group I, II respectively, and there was no significant difference. CONCLUSIONS: These data suggest that some loosening of the tape-tension in TVT procedure has no effect on the success of TVT and improvement of QOL. By some loosening of the tape-tension, postoperative voiding function could be improved and this finding would be helpful especially in patients with preoperative risk factor for voiding dysfunction after TVT.