Efficacy of tension-free vaginal tape with other pelvic reconstructive surgery

Objective: The tension-free vaginal tape procedure has been shown in several studies to be a safe and effective method of correcting stress urinary incontinence, but its efficacy when combined with other pelvic surgery has not been examined. Study Design: Thirty-seven women with stress or mixed urinary incontinence and other pelvic floor defects underwent the tension-free vaginal tape procedure in conjunction with other pelvic floor reconstructive surgery. Preoperative and postoperative voiding diaries, standing stress test results, and patient satisfaction were evaluated. Patient outcome, operative difficulties, and complications are discussed. Results: Thirty-five of 37 patients were completely dry (94%) 6 months after surgery. One patient (2.7%) had a recurrent pelvic floor defect. Four of 37 (10.8%) noted postoperative urgency that required treatment. The overall complication rate was 18.9%: the most common complication was urinary retention (43%); mean number of days with a catheter was 5.1 (range, 0-21 days). No serious operative complications occurred. Nine of 9 (100%) patients who underwent a repeat anti-incontinence procedure were cured with no increase in the complication rate. Conclusion: The tension-free vaginal tape procedure is safe and efficacious when combined with other pelvic floor reconstructive surgery. Postoperative urinary retention was the most common complication. (Am J Obstet Gynecol 2002;186:1292-8.)