Clinical audit of the use of tension-free vaginal tape as a surgical treatment for urinary stress incontinence, set against NICE guidelines

Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology
Natalia Price, S R Jackson

Abstract

Urinary incontinence affects a large proportion of adult women and is associated with considerable distress and social disability. In February 2003 the UK National Institute for Clinical Excellence (NICE) published new clinical guidelines on the use of tension free vaginal tape (TVT) for surgical treatment of stress urinary incontinence. Against these guidelines we have conducted a retrospective audit of patient care by the Oxford Radcliffe NHS Trust over 3 years, using the BFLUTS questionnaire in conjunction with patient records. This is believed to be the first such audit. Our results show overall performance to be satisfactory with no major problems. For all women the type of incontinence was confirmed by urodynamic investigation and in 92% of cases conservative management was tried and had failed before surgery was considered. For the TVT operation patients reported a high subjective cure rate, with 95% either fully cured or showing substantial improvement in their condition. Incidences of the main complications of TVT were found within statistical limits to be low (bladder/urethral perforation 4%; haemorrhage 1%; long-term voiding dysfunction 2%; tape rejection 0%; defective healing 0%; de novo urine retention 12%). These ...Continue Reading

References

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Citations

Jun 6, 2009·International Urogynecology Journal and Pelvic Floor Dysfunction·Natalia PriceSimon Jackson
Aug 19, 2007·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·S I M F Ismail
Nov 9, 2005·Best Practice & Research. Clinical Obstetrics & Gynaecology·Roland Morley, Janine Nethercliffe
Nov 1, 2005·European Journal of Obstetrics, Gynecology, and Reproductive Biology·J-M GirardM Cosson
Apr 15, 2008·Medical Principles and Practice : International Journal of the Kuwait University, Health Science Centre·Farzaneh Sharifiaghdas, Nassrin Mortazavi
Jul 6, 2019·World Journal of Urology·Sandra ElmerCaroline Dowling

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