Research Article| Volume 116, ISSUE 1, P67-70, September 10, 2004

Tension-free vaginal tape (TVT) in women with low urethral closure pressure


      Objective(s): Aim of the study was to assess the effectiveness and the complications associated with the use of tension-free vaginal tape (TVT) in women with stress urinary incontinence and low urethral closure pressure (LUCP). Study design: Thirty-seven patients with stress urinary incontinence and LUCP who were treated with the TVT procedure have been included in the study. Physical examination and urodynamic investigations were carried out to all women preoperatively and at 6, 12 and 26 months (average, range: 22–30 months), postoperatively. The mean age of the patients was 69 years (±13), while mean parity was 2.2 (range 0–3). Results: TVT procedure was carried out in all patients with epidural anesthesia. Postoperative evaluation showed 27 patients (73%) to have been completely cured, four (9.25%) to have a considerable improvement, whereas six patients (16.2%) were classified as failures. Only a few complications occurred. Conclusion(s): Our study indicates that the TVT procedure is an effective and well-accepted minimal invasive surgery for treatment of urinary stress incontinence in women with LUCP. The cure rate of 73% could be considered satisfactory. Women with LUCP and ‘fixed’ urethra, are at significantly increased risk of failure of the procedure.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


        • Thomas T.M
        • Karran O.D
        • Meade T.W
        Prevalence of urinary incontinence.
        Br. Med. J. 1981; 281: 1243-1245
      1. Standon SL, Monga AK, editors. Clinical urogynecology. 2nd ed. Churchill Livingstone; p. 211.

        • Herschorn S
        • Radomski S.B
        Collagen injections for genuine stress incontinence: patient selection and durability.
        Urogynecol. Int. J. 1997; 8: 18
        • Ulmsten U
        • Petros P
        Intravaginal slingplasty: an ambulatory surgical procedure for treatment of female urinary incontinence.
        Scand. J. Urol. Nephrol. 1995; 29: 75-82
        • Monga A
        • Stanton B
        Predicting outcome of colposuspension—a prospective evaluation.
        Neurourol. Urodyn. 1997; 16: 354-355
        • Weinburger M
        • Ostergard D
        Postoperative catheterization, urinary retention and permanent voiding dysfunction after polytetrafluorethylene suburethral sling placement.
        Obstet. Gynecol. 1996; 87: 50-54
        • Jarvis G
        Surgery for genuine stress incontinence.
        Br. J. Obstet. Gynecol. 1994; 101: 371-374
      2. Walters MD, Karram MM. Urogynecology and pelvic reconstructive surgery. 2nd ed. Mosby; p. 179.

        • Keane D.P
        • Eckford S.D
        • Shepherd A.M
        • Abrams P
        Referral patterns and diagnoses in women attending a urodynamic unit.
        BMJ. 1992; 305: 808
        • Hilton P
        • Stanton S.L
        Urethral pressure measurements by microtransducer: the results in symptom-free women and those with genuine stress incontinence.
        Br. J. Obstet. Gynecol. 1983; 90: 919
        • Klutke J.J
        • Carlin B.I
        • Klutke C.G
        The tension-free vaginal tape procedure: correction of stress incontinence with minimal alteration in proximal urethra.
        Urology. 2000; 55: 512-514
        • Moore R.D
        • Speights S
        • Miklos R
        Surgical treatment of stress urinary incontinence and severe pelvic organ relaxation in the medically compromised elderly patient using local anesthesia.
        Obstet. Gynecol. 2000; 95: S56
        • Rezapour M
        • Falconer C
        • Ulmsten U
        Tension-free vaginal tape in stress incontinent women with intrinsic sphincter deficiency—a long-term follow-up study.
        Int. Urogynecol. J. Pelvic Floor Dysfunct. 2001; 12: S12-S14
        • Ulmsten U
        • Johnson P
        • Rezapour M
        A three-year follow-up of tension-free vaginal tape for surgical treatment of female stress urinary incontinence.
        Br. J. Obstet. Gynecol. 1999; 106: 345-350
        • Nilsson C.G
        • Kuuva N
        • Falconer C
        • Rezapour M
        • Ulmsten U
        Long-term results of the tensin-free vaginal tape (TVT) procedure for surgical treatment of female stress urinary incontinence.
        Int. Urogynecol. J. Pelvic Floor Dysfunct. 2001; 12: S5-S8
        • Liapis A
        • Bakas P
        • Creatsas G
        Management of stress urinary incontinence in women with the use of tension-free vaginal tape.
        Eur. Urol. 2001; 40: 548-551
        • Kuuva A
        • Nilsson C.G
        A nationwide analysis of complications associated with the tension-free vaginal tape (TVT) procedure.
        Acta Obstet. Gynecol. Scand. 2002; 81: 72-77