Can Pre-Operative Urodynamic Study Predict the Successful Outcome of Tension Free Vaginal Tape (TVT) Operation in Thai Women with Stress Urinary Incontinence?
Suvit Bunyavejchevin MD, MHS*
Affiliation : * Urogynecology Unit, Department of Obstetric and Gynecology, Faculty of Medicine, Chulalongkorn University
Objective : To study the preoperative urodryramic parameters whether it can predict the outcome of TVT
operation in Thai women with stress urinary incontinence (SUI).
Study
Design : Cohort study.
Materials and Methods : Twenty five Thai women undergone TVT from January to December 2004 at Bumrungrad
Hospital were included in the present study. Urodyramic studies were done pre-operatively. The TVT opera-
tions were carried out with spinal anesthesia. The follow-ups at one, three, and six months were scheduled.
Results : At six months after the operation, the subjective cure rate was 72% (18/25) and 28% (7/25) had the
improved symptoms. Multivariate regression analysis showed the valsava leak point pressure (VLPP) of less
than 60 cm H2O to be associated with the 0.6-fold (0.3-0.9) risk of having successful outcome (being cured).
Anyhow, 7 cases of women not being cured still had improved symptoms and were satisfied with the operation.
Conclusion : The present results confirmed the usefulness of pre-operative urodynamic study in prediction of
the outcome of TVT. Low VLPP (<60 cm. H2O) was associated with poorer outcome of TVT operation in Thai
women.
Keywords : Predicting factor, TVT, Stress incontinence
