Predicting early voiding dysfunction after tension-free vaginal tape

Summary

The purpose of this study was to determine whether early postoperative voiding dysfunction can be predicted before inserting a tension-free vaginal tape (TVT). Multiple parameters including demographic data, history of previous anti-incontinence surgery, anaesthetic type, operator experience, type of surgical procedure (TVT alone or combined with other prolapse surgery) and preoperative urodynamic studies were analysed by univariate analysis and stepwise multiple logistic regression. The data from 500 women were prospectively collected. Early voiding dysfunction occurred in 5.8% of women postoperatively. Using stepwise multiple logistic regression, voiding by other than a detrusor contraction (p = 0.02), preoperative pressure flow rate <15 ml/s (p = 0.04) and general anaesthesia (p = 0.02) were the only factors that predicted early postoperative voiding dysfunction. The point estimate relative risks were 5.6, 11.6 and 4.4 and the positive predicting values were 11.4%, 11.8% and 16.1%, respectively. Despite statistically significant associations with early voiding dysfunction, the positive predictive values of the identified factors remain low, limiting the accurate prediction of early voiding dysfunction.

Keywords:

• Cystometry
• stress incontinence
• tension free vaginal tape (TVT)
• voiding dysfunction