Incontinence Research - Urinary Incontinence, Bladder Control, Treatment, Causes

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Tension-free vaginal tape: do patients who fail to follow-up have the same results as those who do?

Minassian VA, Al-Badr A, Pascali DU, Lovatsis D, Drutz HP

Department of Obstetrics and Gynecology, Geisinger Health System, Danville, Pennsylvania 17822, USA. vaminassian@geisinger.edu

AIMS: To compare success and complication rates of the Tension-free vaginal tape (TVT) between patients with good versus poor follow-up. MATERIALS AND METHODS: A prospective cohort study of 108 women undergoing a TVT procedure was conducted. Patients were seen postoperatively at 6 weeks, 3, 6, 12 months, and yearly thereafter. Patients were categorized as poor follow-up if this schedule was not adhered to. Those who were lost to follow-up at or after their 6-week visit were considered as having failed the procedure. RESULTS: Seventy-nine (73%) patients had good follow-up. Of the remaining 29 patients with poor follow-up, 12 (11%) could not be reached and 17 (16%) were contacted by phone. Reasons given for poor follow-up were: busy or live far from hospital (11), health problems (4), and dissatisfied from surgery (2). Perioperative complication rates were similar between the two groups (P = 0.16). When patients with complete loss to follow-up were analyzed as failures, subjective and objective cure rates were significantly higher in patients with good as opposed to poor follow-up: 92 and 95% versus 72 and 69%, respectively, (P = 0.006). CONCLUSIONS: Patients with poor follow-up probably have lower cure rates after TVT. It is important to follow postoperative patients closely. When reporting success rates, one has to account for all cases to produce realistic results.

Published 15 December 2004 in Neurourol Urodyn, 24(1): 35-8.
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