Journal article

The subjective and objective very long-term outcomes of TVT in the COVID era : a 20-year follow-up

  • Braga, Andrea ORCID Department of Obstetrics and Gynaecology, EOC - Beata Vergine Hospital, Mendrisio, Switzerland ; Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland
  • Caccia, Giorgio Department of Obstetrics and Gynaecology, EOC - Beata Vergine Hospital, Mendrisio, Switzerland
  • Papadia, Andrea Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland ; Department of Obstetrics and Gynaecology, EOC - Civico Hospital, Lugano, Switzerland
  • Castronovo, Fabiana Department of Obstetrics and Gynaecology, EOC - Beata Vergine Hospital, Mendrisio, Switzerland
  • Salvatore, Stefano Department of Obstetrics and Gynaecology, IRCCS San Raffaele Scientific Institute, Milan, Italy
  • Scancarello, Chiara Department of Obstetrics and Gynaecology, University of Insubria, Varese, Italy
  • Torella, Marco Department of Gyanecology, Obstetric and Reproductive Science, Second University of Naples, Naples, Italy
  • Ghezzi, Fabio Department of Obstetrics and Gynaecology, University of Insubria, Varese, Italy
  • Serati, Maurizio Department of Obstetrics and Gynaecology, University of Insubria, Varese, Italy
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  • 2022
Published in:
  • International urogynecology journal. - 2022, vol. 33, p. 947-953
English Introduction and hypothesis: Few studies in literature have assessed the long-term durability and mesh-related complications of mid-urethral slings (MUSs). The aim of this study is to assess the efficacy and safety of retro-pubic tension-free vaginal tape (TVT) 20 years after implantation for the treatment of female stress urinary incontinence (SUI).Methods: A prospective observational study was conducted in two urogynaecologic units in two countries. All the patients involved were consecutive women with urodynamically proven pure SUI treated by TVT. The patients underwent preopera-tive clinical and urodynamic evaluations. Subjective outcomes, objective outcomes and adverse events were recorded during the follow-up period.Results: Fifty-two patients underwent a TVT surgical procedure. Twenty years after surgery, 32 out of 36 patients (88.8%) declared themselves cured (p=0.98). Similarly, 33 out of these 36 patients (91.7%) were objectively cured (p=0.98). No significant deterioration of subjective and objective cure rates was observed over time (p for trend 0.50 and 0.48). Fifteen of the 36 patients (41.6%) at the 20-year follow-up reported the onset of de novo overactive bladder (OAB) (p=0.004). No significant vaginal bladder or urethral erosion or de novo dyspareunia was recorded and no patient required tape release or resection during this period. The cause of death of seven out of ten women who died in the last year of the follow-up period was coronavirus disease 19 (COVID 19).Conclusions: The 20-year results of this study showed that TVT is a highly effective and safe option for the treatment of SUI. The impact of COVID 19 on the mortality rate of elderly women has drastically reduced the number of eligible patients for future evaluations in our region.
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  • English
Classification
Medicine
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CC BY
Open access status
hybrid
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https://n2t.net/ark:/12658/srd1325669
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