Early outcomes of mid-urethral slings for female stress urinary incontinence stratified by valsalva leak point pressure

R. Corey O'Connor, Dana K. Nanigian, Mark B. Lyon, Lars M. Ellison, Gregory T. Bales, Anthony R Stone

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Abstract

Aims: To assess the early results of mid-urethral slings placed via the transobturator approach (TVT-O) for stress urinary incontinence (SUI) in women with high (>60 cm H2O) and low (≤60 cm H2O) valsalva leak point pressure (VLPP). Materials and Methods: Forty-three women with urodynamically proven SUI underwent TVT-O. Patients were divided into either high (>60 cm H2O) or low (≤60 cm H2O) VLPP categories based on preoperative urodynamic studies. Patient outcomes were assessed based on degree of postoperative SUI as either dry (no pads, no SUI), or wet (any leakage). Follow-up visits were at 1, 6, 12, and 24 weeks. Results: Overall, 65% (28/43) women were cured following TVT-O for SUI. When stratified based on preoperative VLPP, 77% (24/31) of patients with VLPP greater than 60 were cured while only 25% (3/12) of patients with VLPP less than or equal to 60 were cured. No intraoperative complications were noted. The odds of continued SUI following TVT-O were 12 times greater for women with VLPP <60 compared to those with VLPP >60. Conclusions: With limited follow up, TVT-O appears to be a safe and effective surgical treatment for female SUI producing excellent results in patients with VLPP >60 cm/H2O. Patients with low VLPP may consider conventional, retropubic mid-urethral slings or other procedures as treatment for SUI.

Original languageEnglish (US)
Pages (from-to)685-688
Number of pages4
JournalNeurourology and Urodynamics
Volume25
Issue number7
DOIs
StatePublished - 2006

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Keywords

  • Incontinence
  • Leak point pressure
  • Outcome

ASJC Scopus subject areas

  • Clinical Neurology
  • Nephrology
  • Urology

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