Does the tension-free vaginal tape stay where you put it?

Am J Obstet Gynecol. 2003 Apr;188(4):950-3. doi: 10.1067/mob.2003.268.

Abstract

Objective: The tension-free vaginal tape (TVT) is a widely used procedure for the surgical treatment of urodynamic stress incontinence. Long-term follow-up data remain scarce. It has been speculated that scar formation leads to tape shortening and stiffening. This study was designed to longitudinally investigate tape position and mobility.

Study design: An observational clinical study was performed using ultrasound parameters of tape position and mobility on Valsalva maneuver as main outcome parameters.

Results: Of 92 women eligible for a minimum of two postoperative assessments, 72 (78%) attended at least twice after TVT placement, at a median interval of 1.6 years. Sixty-eight data sets remained after exclusion of 4 patients who had undergone tape division. At the last visit, the tape was found to be more caudal, at rest (P <.001) and on Valsalva maneuver (P =.002). Tape mobility on Valsalva maneuver remained virtually unchanged.

Conclusion: The TVT does not seem to contract or shorten over a median observation period of 1.6 years. On the contrary, it appears to slowly migrate caudally.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Female
  • Foreign-Body Migration / physiopathology
  • Humans
  • Longitudinal Studies
  • Middle Aged
  • Prostheses and Implants* / adverse effects
  • Prosthesis Failure
  • Time Factors
  • Ultrasonography
  • Urinary Bladder / diagnostic imaging
  • Urinary Incontinence, Stress / diagnostic imaging
  • Urinary Incontinence, Stress / surgery*
  • Urologic Surgical Procedures*
  • Vagina* / diagnostic imaging
  • Valsalva Maneuver