Study design, materials and methods
Among 110 women with SUI who underwent the TVT procedure between March 1999 and December 2000, 51 patients were followed up for at least 17 years postoperatively. Preoperative evaluation of the patients was performed with history taking, physical examinations, one-hour pad tests, urine analysis, urine cultures and complete multichannel urodynamic studies. Long-term evaluations were performed via questionnaires on the durability of the surgical outcome and the patients' satisfaction with the procedure. All the patients were asked about their voiding symptoms as well as any recurrence by conducting detailed telephone interviews.
Results
The mean follow-up period was 207.62 ± 8.46 months. Of the 51 patients who were followed up for at least 17 years, the patients were classified according to their symptom grades; grade I (n = 13, 25.49%), grade II (n = 28, 54.90%) and grade III (n = 10, 19.61%). The TVT procedure remained successful in 42 patients (82.35%): SUI was remained cured in 28 patients (54.90%) and improved in 14 patients (27.45%) while recurred incontinence was observed in 9 patients (17.65%). According to the telephone interviews, 26 patients (50.98%) were very satisfied and 16 patients (31.37%) were satisfied with the TVT procedure. However, 6 (11.76%) and 3 (5.88%) patients answered 'tolerable' and 'dissatisfied', respectively, and all of these patients had recurred SUI. Among the investigated patients, no serious or long-term complications related to the procedure were observed.
Interpretation of results
According to the present results, more than 80% of the females who underwent TVT to manage SUI were remained cured or improved, and a similar rate of patients were at least satisfied at 17-years after the surgery. This implies that TVT is an effective and durable surgical procedure to manage females with SUI. However, since only 46.36% of the patients were able to be contacted to for the telephone interviews, the results of this study may not be sufficiently robust to evaluate the long-term success and satisfaction of females who underwent TVT. Further multi-institute cohort studies with prospective design are necessary to validate the precise effectiveness and durability of TVT in SUI females.