Midurethral sling system is the gold standard surgical treatment for female stress incontinence. TVT-abbrevo is a 12cm transobturator midurethral sling with the postulated advantage of reduced post-operative groin and thigh pain, while maintaining similar efficacy to its predecessors (TVT-O). We aim to assess the efficacy of TVT-abbrevo, and the outcomes at 5 years follow-up at our centre.

We conducted a retrospective study on all patients who underwent TVT-abbrevo from 1 September 2011 – 30 September 2013. Patients were reviewed for satisfaction, recurrence of symptoms, and post-operative side effects at 1 month, 6 month, 12 months and then yearly up to 60 months.

93 patients underwent TVT-abbrevo during the 25 months. At this point of writing, 87 patients have completed 4 year follow up, while 53 patients have completed 5 year follow up. 6 patients were lost to follow up. 91.4% had previous vaginal or instrumental deliveries. The average BMI was 26.8kg/m2. 46.2% had concomitant urinary urge incontinence. 65.6% had demonstrable stress incontinence, with an average of 12.9gm of urine leaked on erect stress test. The mean operating duration was 14.3 minutes. There were 3 cases of bladder perforation and 4 cases of vaginal perforation. The mean hospitalization stay was 1.1 days, and mean catheterization duration was 0.8 days. None of the patients had prolonged catheterization (> 7 days) post-operatively. Three patients had wound pain at 6 months, which resolved at 12 months. Post TVT-abbrevo at 6 months, only one patient had demonstrable leak of urine. Three patients had mesh extrusion at 6 months, and one patient had mesh extrusion at 12 months. Of the 43 patients with pre-existing urge urinary incontinence, 27 had their symptoms resolved by 6 months post operatively, while 12 patients felt an improvement in their symptoms at 6 months. 19 patients had pre-operative voiding difficulty. Of which, only one patient felt there was no improvement in symptoms post-operatively up to 48 month follow up.

Objective cure rate were 98.9% at 6 months, 98.8% at 12 months, 98.8% at 24 months, and 100% at 36, 48 and 60 months. Patient satisfaction persistently achieved above 95% across all 5 years.

TVT-abbrevo is an excellent alternative for female stress incontinence, with high patient satisfaction and low long term complication rates at 5 years.