Preoperative urodynamic predictors of short-term voiding dysfunction following a transobturator tension-free vaginal tape procedure

Abstract

Objective: To determine whether preoperative urodynamic parameters can predict the development of short-term voiding dysfunction (VD) after a transobturator tension-free vaginal tape (TO-TVT) procedure.

Methods: In a prospective study between April 2005 and April 2007, 341 women were randomized to receive "inside-out" or "outside-in" TO-TVT. The present secondary analysis included women who had completed a preoperative symptom questionnaire, had a voided volume of 100mL or more on preoperative uroflowmetry, and underwent standardized postoperative voiding assessment. VD was defined as a requirement for postoperative catheterization. Univariate and multivariate analysis were done by SPSS 17.

Results: The inclusion criteria were met by 224 women, of whom 17 (7.6%) had postoperative VD. On univariate analysis, there were no differences in preoperative parameters among those with and those without VD: residual urine volume (P=0.485), peak flow rate on or below 5th centile (P=0.272), average flow rate on or below 5th centile (P=0.142), detrusor pressure at opening (P=0.955), maximum urethral closure pressure at 30 cm H(2)O or less (P=0.855) and functional urethral length (P=0.173). None of the variables analyzed was an independent risk factor on multivariate analysis.

Conclusion: Preoperative urodynamic parameters did not predict the development of short-term voiding dysfunction after a TO-TVT procedure.