Holmgren, C., Nilsson, S., Lanner, L. And Hellberg, D.
The aim of this study was to identify the risk factors for developing de novo urinary urgency symptoms following the tension-free vaginal tape (TVT) procedure in women with stress urinary incontinence. A structured preoperative analysis of incontinence symptoms was made, and a mailed questionnaire was distributed to 970 women who underwent TVT surgery between 1995 and 2001, the average follow up being 5.2 years with a range of 2 – 8 years. Of the patients surveyed, 78.3%(760) responded to the questionnaire, which included specific questions on their current urinary symptoms and incontinence. The disease-specific quality of life instruments IIQ-7 and UDI-6 were used to compare women with and without de novo urgency. Of the respondents, 463 were identified as genuine stress incontinence preoperatively, and de novo urgency occurred in 14.5% (67) of the respondents at the time of the questionnaire, with the frequency similar regardless of follow up duration. Risk factors for development of de novo urgency symptoms following TVT were considered to be: Older age (65.7 vs 60.9 years; p=0.01), Parity (2.6 vs 2.3; p=0.05), History of Caesarean delivery (9.5% vs 2.5%; odds ratio 5.4), History of recurrent UTI (29.7% vs 18.8%; odds ratio 1.6 but non-significant). De novo urgency was found to have a severe impact on quality of life when compared to the population who did not report these symptoms, and in some cases were as bothersome as the original stress incontinence.
European Journal of Obstetrics & Gynaecology and Reproductive Biology, 132 (1), 121-125