MID-TERM OUTCOMES OF ADJUSTABLE TENSION-FREE VAGINAL TAPE SURGERY IN THE TREATMENT OF COMPLEX FEMALE STRESS URINARY INCONTINENCE AT UNIVERSITY MEDICAL CENTER HO CHI MINH CITY
Main Article Content
Abstract
Background: While Tension-free Vaginal Tape (TVT) has been the gold standard for treating female stress urinary incontinence (SUI) for three decades, determining optimal tape tension remains a significant challenge in complex cases (intrinsic sphincter deficiency, non-hypermobile urethra, or recurrent SUI). Suboptimal tension leads to persistent leakage, whereas excessive tension may cause voiding dysfunction or urinary retention. Adjustable TVT (TVT-A) allows for individualized post-operative tension refinement (tightening or loosening) to achieve a balance between continence and voiding efficiency. This study aims to evaluate the mid-term outcomes and safety of TVT-A in patients with complex SUI at University Medical Center Ho Chi Minh City.
Methods: This retrospective, descriptive case series included women with complex stress urinary incontinence (SUI) who underwent TVT-A surgery between 2021 and 2025 at the Department of Functional Urology, University Medical Center Ho Chi Minh City. Data regarding surgical outcomes, tape adjustment rates, and complications were recorded and analyzed via medical records.
Results: The study included 25 cases. The mean age was 57 ± 9.9 years (43-79); mean BMI was 23.9 ± 3.5 kg/m2 (18.7-31.9). The mean operative time was 63.2 ± 26.3 minutes (25-135). Mean blood loss was low (50-100 mL). Intraoperative complications occurred in 12% (3/25) of cases, including two bladder perforations and one case of bladder mucosal hemorrhage; all were safely managed intraoperatively. Post-operative tape adjustment was required in 44% (11/25) of patients. The mean hospital stay was 2.5 ± 1.2 days (1-6). After a mean follow-up of 28 ± 15.1 months (5.3-47.9), the complete cure rate reached 92% (23/25), with an improvement rate of 8% (2/25). No late complications were recorded; 100% of patients reported satisfaction with the treatment outcome.
Conclusion: Mid-term results demonstrate that TVT-A is an effective and feasible option for complex female SUI due to its individualized post-operative tension adjustment strategy. Routine intraoperative cystoscopy effectively manages surgical risks, leading to sustainable success and high patient satisfaction.
Keywords
Complex stress urinary incontinence, Adjustable tension-free vaginal tape, Intrinsic sphincter deficiency, Non–hypermobile urethra
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References
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