J Korean Med Sci.  2005 Dec;20(6):1006-1010. 10.3346/jkms.2005.20.6.1006.

Risk Factors of Voiding Dysfunction and Patient Satisfaction After Tension-free Vaginal Tape Procedure

• Park S
• Hong B
• Lee KS
• Choo MS

• KMID: 2157753
• DOI: http://doi.org/10.3346/jkms.2005.20.6.1006

Abstract

This study was undertaken to identify risk factors for postoperative voiding dysfunction and factors having impact on patient global satisfaction after a tension-free vaginal tape (TVT) procedure. Two hundred and eighty-five women who underwent the TVT procedure for stress urinary incontinence were analyzed to identify risk factors predictive of voiding dysfunction. Postoperative voiding dysfunction was defined as a peak urinary flow rate (PFR) <10 mL/sec (straining voiding, n=17) or residual urine volume >30% of bladder capacity (incomplete emptying, n=13). The global satisfaction rate was 91.6%. Voiding dysfunction developed in 29 (10.2%) patients. Among the factors, PFR was only factor of significance for voiding dysfunction. There was no significant difference between patients with and without voiding dysfunction in terms of their satisfaction. But postoperative PFR <10 mL/sec significantly compromised global satisfaction after the surgery. In those patients with a preoperative PFR <20 mL/sec, there were more patients with postoperative PFR <10 mL/sec. Peak urinary flow rate is an important factor for the postoperative voiding dysfunction. The inevitable decline in PFR can compromise patients' satisfaction with the procedure, when their postoperative PFR was <10 mL/sec.

Keyword

Tension-free Vaginal Tape; Urinary Incontinence; Patient Satisfaction; Physiopathology; Dysfunction; Urination Disorders

MeSH Terms

Adult
Aged
Aged, 80 and over
Female
Humans
Middle Aged
Patient Satisfaction
Risk Factors
Surgical Procedures, Minimally Invasive/methods
Urinary Incontinence, Stress/*physiopathology/psychology/*surgery
Urologic Surgical Procedures/methods
Vagina/surgery

Figure

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  Fig. 1 ROC curve for peak flow rate. Area under curve was 0.684. Sensitivity and specificity were 22.3% and 55.2% at 20.9 mL/sec, respectively. This means peak urinary flow rate may estimate the risk of voiding dysfunction as effectively as it predicts postoperative urinary retention.

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