Treatment outcome of tension-free vaginal tape in stress urinary incontinence: comparison of intrinsic sphincter deficiency and nonintrinsic sphincter deficiency patients

The object of this study was to compare the treatment outcomes of tension-free vaginal tape (TVT) for intrinsic sphincter deficiency (ISD) and nonintrinsic sphincter deficiency (NISD) patients in stress urinary incontinence (SUI) and to evaluate whether TVT can be effectively used in both groups of patients. 111 women with SUI treated by TVT procedure from June 2003 to June 2005 with follow-ups for at least 1 year postoperatively were included in this study. The patients were divided into two groups: 31 patients with ISD and 80 patients with NISD. ISD was defined as the cases with low Valsalva leak-point pressure (VLPP) or Maximal urethral closure pressure (MUCP). Patients were followed up at 1, 3, 6, and 12 months postoperatively. There were no significant differences found in demographics between ISD and NISD groups: mean age, parity, body mass index, menopausal status, and hormone replacement therapy (p > 0.05). All urodynamic parameters except for VLPP and MUCP showed no significant differences. The cure rates of the two groups at 1 month follow-up (87.0 vs 100%; p = 0.0053) showed a significant difference, but no significant differences were found at 3, 6, and 12 months. There were no differences in postoperative complication rates (voiding difficulty, de novo urgency, urinary tract infection, retropubic hematoma, and vaginal mesh erosion) between the two groups irrelevant of follow-up months. TVT is effective for SUI in both ISD and NISD patients.