Long-term and good quality follow-up data on the safety and efficacy of midurethral slings are limited. A recent prospective single-centre observational study evaluated subjective, objective, and urodynamic outcomes of the Gynecare TVT at 13-years. It updates a previous study evaluating 10 year outcomes. In the present study, 55 women who had a TVT (Ethicon, Gynecare) procedure between January 2000 and June 2001, are studied. There were originally 63 women; eight patients (12.7%) were lost to follow-up or were not evaluable.
Forty-seven of 55 (85.5%) patients declared themselves cured and 48 (87.2%) were at least improved. There was a trend that satisfaction decreases over time. At the last evaluation 50 out of 55 (90.9%) women were objectively cured and 49 out of 55 (89.1%) also confirmed this finding on UDS evaluation.
Obesity, intravesical opening pressure and maximum detrusor pressure during the voiding phase were associated with subjective recurrent SUI. Multivariate analyses confirmed that obesity (HR 7.2; P=0.01) and maximum detrusor pressure during the voiding phase ≤29cmH2O (HR 8.0; P =0.01) were the only independent predictors of recurrence of SUI. Moreover, obesity represented the only independent predictor of objective recurrence of SUI (HR 17.6; P=0.01) and of urodynamic recurrence of USI (HR 8.9; P=0.01).
Although this study included a small cohort of patients, one of the strengths is the reporting of subjective, objective and urodynamic outcomes of TVT with a follow-up longer than 10 years. No late mesh-related complications appeared during the study period.
Article by the Publications and Communications Committee