Tension-free vaginal tape (TVT) for treatment of stress urinary incontinence in women with low-pressure urethra.

Objective: To assess the results of TVT in patients with urinary stress incontinence, urethral hypermobility, and low-pressure urethra.

Study Design: We retrospectively analysed 265 consecutive women who underwent a TVT procedure for urodynamic stress urinary incontinence over a 31-month period. Women were divided into two groups depending on their preoperative maximum urethral closure pressure (MUCP). Group 1 (61 women with MUCP20 cm H2O. Subjective and objective outcome data were assessed from routine postoperative visits. Office and hospital records were reviewed to check patients' characteristics, intraoperative findings, and surgical outcomes.

Results: Women with low-pressure urethra were older than those with MUCP>20 cm H2O; they were more likely to have had a hysterectomy or anti-incontinence surgery. The mean duration of follow-up was 31 (+/-11) months. Cure rates among patients with low- or normal-pressure urethra were similar (77% and 86%, P=0.70). Nevertheless, the former were more likely to complain of voiding dysfunction.

Conclusion: TVT is a highly effective treatment even in women with intrinsic sphincter deficiency.