Stress urinary incontinence is common condition in elderly women. With the growing number of elderly female patients with stress urinary incontinence (SUI) a safe treatment procedure with little invasiveness, high efficacy, and good reproducibility is in great demand. The aim of our study to evaluate the efficacy and safety of the transobturator vaginal tape (TVT-O) for the surgical management of stress urinary incontinence  in elderly non obese women.

Between 2011 and 2017, 114 elderly women (≥65 years old) with stress urinary incontinence (SUI) undergoing to directly TVT-O procedure were prospectively enrolled in this study. Patients were divided into two groups by age: older women (≥75 years old) were included in group A,  younger women (<75 years old) in group B. Intra- and post-operative outcomes were compared between the groups. Outcome measures were operative complications, early and late postoperative morbidity, postoperative stress urinary incontinence, incidence of de novo overactive bladder and bladder outlet obstruction. Including criteria was post-menopausal patients with symptoms, with objectively proven stress incontinence or stress predominant mixed incontinence confirmed on urodynamic testing and had consented for surgery.

During the study period all women met the inclusion criteria and were included for final analysis. Among these women, 46 (40.3%) and 68 (59.6%) were included in groups A and B respectively. Mean follow-up of the patients was 35 ± 12 months (range 3-58 months). Early and late postoperative morbidity was similar in both groups, postoperative stress urinary incontinence was similar in both age groups (4%). The incidence of overactive bladder was similar in two groups (56% and 50%, respectively), while de novo OAB was significantly more common in elderly patients (11.9% vs. 4.7%, P<0.05). No differences were observed in terms of voiding dysfunction, vaginal erosion and persistent groin pain. Inpatient stay period was similar for both groups - 1 day.

Transobturator vaginal tape (TVT) surgery results for the treatment stress urinary incontinence in elderly women was showed good results with less complication rates including to this study (table).

TVT-O is safe and effective procedure for the management of stress urinary incontinence in elderly population. Surgery has been proven highly effective for the treatment of SUI in older women participating in large clinical trials, but carries risks of postoperative complications. Selected older women have been demonstrated to do well with TVT O surgery and have well improving quality of life.