Long-term results with tension-free vaginal tape on mixed and stress urinary incontinence

Objective: To compare outcome of the tension-free vaginal tape (TVT) procedure in women with urinary mixed and stress incontinence. Methods: A mailed questionnaire was answered by 760 of 970 women who had undergone TVT surgery 2-8 years ago (78% response rate). Seventeen women had unclassified incontinence, and 51 women who developed de novo urgency were excluded, giving 580 (83.8%) with stress incontinence and 112 (16.2%) women with mixed incontinence eligible for analysis. Demographic, reproductive factors, and medical history were obtained. The questionnaire included detailed questions about urinary symptoms. Analysis of outcome was done for cohorts by number of years since the operation. Results: The women with stress incontinence had a persistent cure rate of 85% from 2 to 8 years after the TVT procedure. The women with mixed incontinence had a persistent cure rate of 60% up to 4 years postoperatively, but the cure rate then steadily declined to 30% from 4 to 8 years after surgery. The increased rate of incontinence was due to urgency symptoms. Conclusion: The results of this study indicate that initial good cure rates of TVT for mixed incontinence do not persist after 4 years.