Transobturator tension free vaginal tape surgery for stress urinary incontinence increases post-operative residual urine and decrease the peak flow rate in elderly female
Huang Liang-kang (1)
(1) Linkou Chang Gung, , Taiwan
To find out if tension free vaginal tape accessed from trasobturator rout alters voiding function in elderly female.
We reviewed chart of stress urinary incontinence patients who took GYNECARE TVT Obturator System (Ethicon, USA) from 2012-2018. The ages of patients ranged from 41 to 80 years old and mean patients age was 58.47±8.09. Urodynamic data including peak flow rat, residual urine, maximum urethra closing pressure, and bladder capacity pre and post operation were collected. We defined elderly patients as patient who was over 75 years old when performing the surgery.
Between 2012 to 2018, there are 267 patient who suffered from stress urinary incontinence and had a tension free vagina tape surgery. 167 patients completed both pre-operative and post operative urodynamic study 3 months after surgery. In these 167 patients, 56 patients were elderly female. In the younger patients, the parameter including peak flow rate, residual urine, bladder capacity, and maximum urethra closing pressure are of no statistical difference before and post sling surgery. However, in elderly patients group, there are some difference urodynamic parameters before and after surgery. Peak flow rate was decreased after surgery 24.99±2.10 vs 17.42±1.09 ml/sec (p=0.0021) while residual urine was increased 18.26±3.03 vs 37.12±6.89 ml (p=0.0147). Bladder capacity and maximum urethra closing pressure were remained unchanged. Bladder capacity was 337.8±22.28 vs 359.0±19.87 ml (p=0.480), and maximum urethra closing pressure was 55.46±3.80 vs 47.50±3.31 cm/H2O (p=0.121).