Can pre-operative urodynamic study predict the successful outcome of tension free vaginal tape (TVT) operation in Thai women with stress urinary incontinence?

OBJECTIVE To study the preoperative urodryramic parameters whether it can predict the outcome of TVT operation in Thai women with stress urinary incontinence (SUI). STUDY DESIGN Cohort study. MATERIAL AND METHOD Twenty five Thai women undergone TVT from January to December 2004 at Bumrungrad Hospital were included in the present study. Urodyramic studies were done pre-operatively. The TVT operations were carried out with spinal anesthesia. The follow-ups at one, three, and six months were scheduled. RESULTS At six months after the operation, the subjective cure rate was 72% (18/25) and 28% (7/25) had the improved symptoms. Multivariate regression analysis showed the valsava leak point pressure (VLPP) of less than 60 cm H2O to be associated with the 0.6-fold (0.3-0.9) risk of having successful outcome (being cured). Anyhow 7 cases of women not being cured still had improved symptoms and were satisfied with the operation. CONCLUSION The present results confirmed the usefulness of pre-operative urodynamic study in prediction of the outcome of TVT. Low VLPP (<60 cm. H2O) was associated with poorer outcome of TVT operation in Thai women.