Evaluation Of The Effectiveness Of Cough Test During Tension-free Vaginal Tape Procedure In Preventing The Post-operative Voiding Dysfunction

Objective To assess the practical value of the cough test in thetension-free vaginal tape (TVT) procedure.Methods A cohort of85women with stress urinary incontinence（SUI）underwent the TVT procedure with cough test (n=41) or without cough test(n=44). Operations in cough test group were finished on the basis of theUlmsten’s steps completely, with the stress of the tape regulated under theguidance of cough test; whereas in other44operations, the tape withoutstress was placed on the urethral tract, not adjusted by cough test. The urinecatheter was removed after48hours postoperatively and follow-upevaluation was carried out at12month postoperatively.Results TVT procedure was carried out successfully in all patients bythe single experienced surgeon.4cases of urinary retention as well as5cases of voiding difficulty were observed in the cough test group. However,urination dysfunction (e.g., urinary retention, voiding difficulty) was not detected in the non-cough test group. According to the twelve-month followup, the cure rate was92.6%(38/41) in the cough test group and93.1%(41/44) in the non-cough test group. Flow-pressure study indicated that11cases in the cough test group were observed in the obstruction zone, whileonly3cases in the obstruction zone were detected in the non-cough testgroup.Conclusion TVT is a safe as well as effective surgical method to curefemale stress urinary incontinence with minimal invasion to the patients.However, Adjusting stress of tape in accordance with cough test during theTVT may potentially increase the incidence of urination dysfunctionpostoperatively. Therefore, no convincing evidence was gained to supportthe efficacy of cough test during TVT in terms of preventing postoperativevoiding dysfunction.