Can urethral retroresistance pressures predict midurethral sling outcomes?

Objective: To determine whether preoperative urethral resistance pressure (URP) measurements could predict success or failure of a tension-free vaginal tape (TVT) sling.

Methods: Subjects came from a previously published study comparing URP measurements to a validated urinary incontinence symptom survey (UISS). We contacted patients from that study to determine whether they had subsequently undergone TVT surgery. Within that cohort, we determined the "current" (i.e., postoperative) UISS and Sandvik urinary incontinence severity score. Success of a TVT sling in this group was defined in 4 ways: (1) postoperative UISS score <3, (2) postoperative UISS score < 75% of the preoperative score, (3) postoperative Sandvik score <6, and (4) postoperative Sandvik score <2. These definitions of "success" were compared across demographic and treatment variables using the Student's t test, ANOVA, chi2 and ROC curves.

Results: We contacted 69 women who had in fact received a TVT sling after their participation in the previously published study mentioned above. Among these 69 women, mean preoperative urethral retroresistance pressure values were not predictive of surgical success.

Conclusion: Preoperative urethral retroresistance pressure measurements did not reliably predict surgical success or failure; therefore, this urodynamic test is of little value to the clinician.