Long-term Efficacy And Influencing Factors Of TVT-O In The Treatment Of Female Stress Urinary Incontinence

Objective: To investigate the effect of Trans-obturator tension free vaginal tape(TVT-0)and the risk factors affecting the postoperative effect.Methods: The clinical data of female patients with stress urinary incontinence who underwent TVT-0 surgery in the First Affiliated Hospital of Xinjiang Medical University from March 2014 to October2019 were retrospectively analyzed,and long-term follow-up was performed.During the follow-up period,the subjective results of the patients were collected,namely,the preoperative and postoperative changes of the subjects were studied according to the International consultation committee on incontinence questionnaire short form,ICIQ-SF,and the efficacy was judged as cure,improvement,and failure.Multivariate Logistic regression analysis model was used to identify the related factors affecting the efficacy of TVT-0 surgery.Results:A total of 101 patients were included,and the subjective degree of incontinence was the standard,with 47 cases of moderate incontinence and 54 cases of severe incontinence.The differences between the two groups showed that age,menopause,course of disease,and patients with underlying diseases affected the degree of incontinence,which was positively correlated(P<0.05).Follow-up was 36 to 96 months.The mean follow-up was 61 months.The long-term follow-up showed a cure rate of 73.2%,an improvement rate of 23.8%,and a failure rate of 3.0%.No significant decrease in the cure rate was observed over time.ICIQ-SF scale was filled in before and after operation,and scores of the scale were compared,the differences were statistically significant(P<0.05).Defect of urethral sphincter(OR=11.196,95%CI: 2.057～60.923,P=0.005),age(OR=6.737,95%CI: 1.214～37.375,P=0.029),birth(OR=8.944,95%CI:2.435～32.856,P < 0.01)were the risk factors that affected the postoperative efficacy.Conclusion:(1)Long term follow-up is of great significance to comprehensively evaluate the durability and safety of the efficacy of TVT-O.(2)TVT-0 surgery has high long-term efficacy and safety,and patients’ postoperative satisfaction is high.It is recommended for the treatment of female stress urinary incontinence,the patient’s age,birth power and urinary sphincter defects may affect the postoperative efficacy.