Long-Term Outcomes of Tension-Free Vaginal Tape Procedures in Argentine Women: Our First Report After 20 Years

Long-term outcome of the retropubic TVT procedure for women with stress urinary incontinence: 20-25-year follow-up

INTRODUCTION

Stress urinary incontinence (SUI) significantly affects women's quality of life. The tension-free vaginal tape (TVT) procedure has demonstrated short- and medium-term efficacy, but data beyond 15 years remain scarce. This study evaluates the 20- to 25-year outcomes of the retropubic TVT procedure in terms of efficacy, safety, and patient satisfaction.

METHODS

This retrospective cohort study included 135 women that underwent the retropubic TVT procedure between 1998 and 2003. All surgeries were performed by two surgeons using the Gynecare TVT™ Sling. Data were obtained from medical records, follow-ups, and telephone interviews (January-March 2024). Outcomes were assessed using the Patient Global Impression of Improvement (PGI-I), International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), and Urinary Distress Inventory-Short Form (UDI-6).

RESULTS

Out of 593 women originally treated, 135 completed long-term follow-up. The mean age at surgery was 50.3 years and 72.5 years at follow-up. The median PGI-I score of 2.0 indicated that 76.3 % of patients reported significant improvement. The median ICIQ-SF score was 7.0, reflecting moderate symptom burden, and the median UDI-6 score was 22.2, with 20 % of patients reporting significant urgency symptoms. Postoperative complications were low; 85.9 % of patients had no complications, 13.3 % experienced urinary retention, and 0.7 % had tape erosion. Repeat TVT was required in 9.6 % of cases, with significantly lower satisfaction (p = 0.002). PGI-I scores strongly correlated with ICIQ-SF (r = 0.801, p < 0.01) and UDI-6 (r = 0.676, p < 0.01).

CONCLUSIONS

TVT remains an effective long-term SUI treatment with high satisfaction and low complications. Long-term follow-up is essential for monitoring late-onset complications.

Long-Term Outcomes Associated with the Use of a Soft, Partially Absorbable Transobturator Mid-Urethral Tape for the Treatment of Stress Urinary Incontinence

Objectives: To assess the long-term safety and efficacy of the Serasis® inside-out transobturator midurethral sling (MUS), a partially absorbable soft tape for stress urinary incontinence (SUI). Methods: A cohort study of 146 consecutive women who underwent the Serasis® MUS procedure from January 2013 to January 2014 was investigated. All patients had SUI as the main complaint. Patients with predominant urgency urinary incontinence (UUI) and stage III-IV pelvic organ prolapse were excluded. Clinical, intraoperative, and postoperative data were retrospectively retrieved from a computerized database. At 10 years postoperatively, a follow-up telephone survey was conducted. The patients were interviewed regarding tape-related complications, repeated SUI surgery, and decision regret or satisfaction. Results: All patients underwent the Serasis® MUS procedure, most of whom also had concomitant colporrhaphies. The mean duration of surgery was 26.03 min, and the mean blood loss was 32.4 cc. All patients were discharged within a few hours after surgery or on the following day. No significant intraoperative or early postoperative complications were reported. Overall, 107 (73.3%) patients were available for the 10-year follow-up, 17 (15.9%) of whom reported symptoms of SUI, but only half of them underwent a repeated MUS. The rate of tape erosion was 1.9%, and no symptoms of tape-related pain were reported. Additionally, 10.3% of the patients were categorized as a subjective failure, most of whom considered persistent UUI as the main reason for dissatisfaction. Conclusions: The long-term outcomes of the transobturator Serasis® MUS, a partially absorbable soft tape, are favorable and are associated with significantly fewer tape-related complications.