Evaluating long-term outcomes of TVT-A for stress urinary incontinence in women

This study evaluated the long-term outcomes of tension-free vaginal tape ABBREVO (TVT-A) surgery in patients with stress urinary incontinence. This study found that this treatment was safe and effective.

Stress urinary incontinence (SUI) is leakage of urine under physical pressure, such as while coughing, sneezing, or lifting a heavy object. Surgery is one treatment option for women with SUI. This surgery implants a medical device called tension-free vaginal tape (TVT) to help support the urethra and prevent urine leakage.

One type of TVT surgery is called TVT-O. This surgery avoids the pubic area, which lowers the risk of complications. However, TVT-O is associated with thigh or groin pain. TVT-A surgery avoids using scissors and has a shallower cut. This means that there is less pain after surgery. However, the long-term outcomes of patients who have TVT-A surgery are unclear.

This study included 41 women with SUI who were eligible for surgery. All patients underwent TVT-A surgery. Patients were followed-up yearly after the surgery for a total of 3 years.

Immediately after the surgery, 61% of patients reported groin or thigh pain. The day after surgery, this rate was 22%. At 1 month and at 1 year after surgery, no patients reported pain.

At follow-up, 90% of patients reported their SUI was much improved and were satisfied with the surgery. 92.5% did not have incontinence during a stress test. 1 year later, 4.9% of patients developed overactive bladder (OAB). 3 years later, this rate was significantly higher (15%).

At follow-up, 4.9% (2 patients) had the mesh tape wear through vaginal tissue. This was treated with estrogen cream and surgery. Tape removal was not needed for either of these patients.

The study found that TVT-A is a highly effective and safe treatment for women with SUI. The authors suggest that some patients may develop overactive bladder after this procedure.

This study had a small number of patients. Larger studies are needed to confirm these results. Because TVT-A is not as widely used as conventional TVT-O surgery, more studies are required in order to evaluate the long-term outcomes of TVT-A.

Talk to your doctor to see if TVT-A surgery may be the right option for you.