Tension-Free Vaginal Tape - Eine Literaturübersicht

Zusammenfassung

Einführung: Seit 1996 wird zur Inkontinenztherapie weltweit immer häufiger das TVT (tension-free vaginal tape) verwendet. Das Ziel dieser Studie war die Effektivität, Sicherheit und Komplikationen der TVT-Operation am Menschen im Sinne einer Literaturübersicht zu erfassen.

Material und Methoden: Es wurde eine Medline-Suche von Januar 1994 - Januar 2003, mit dem Suchbegriff: „tension free vaginal tape“ durchgeführt. Eingeschlossen wurden alle Artikel auf Englisch, Französisch und Deutsch.

Ergebnisse: Es fanden sich 106 Artikel. Die Erfolgsraten wurden zwischen 59 und 100 % angegeben. Häufige Komplikationen traten in bis zu 60 % auf und beinhalteten: Blasenperforationen, Blasenentleerungsstörungen, Harnwegsinfekte, De-novo-Urge, De-novo-Detrusorinstabilität, Blutungen, Hämatome, Schmerzen. Als seltene Komplikationen wurden in bis zu 3,3 % beschrieben: Erosion von Vagina, Urethra oder Blase, Vaginaverletzung, Urethraverletzung, Gefäßverletzung, Nervenläsion, Darmläsion, Urethrafistel, vesikovaginale Fistel, Wundinfekt, Wundheilungsstörung, Schlingenabstoßung, technische Probleme, Venenthrombose, akute Niereninsuffizienz, Sepsis, Herzinfarkt, Tod.

Schlussfolgerung: TVT ist ein sicheres erfolgreiches Verfahren zur Therapie der Inkontinenz mit guten mittelfristigen Ergebnissen. Wegen der zum Teil sehr unterschiedlichen Einschlusskriterien (Stressinkontinenz oder Stress-Urge-Inkontinenz, nur TVT oder kombinierte Operationen, Voroperationen), Definitionen (Heilung, Verbesserung, Komplikationen), Studienarten (nur 3 prospektiv randomisierte Studien) und Fallzahlen (19 Studien mit < 50 Patientinnen), ist eine einheitliche Beurteilung der Studien schwierig.

Abstract

Introduction: Since 1996, TVT (tension-free vaginal tape) is increasingly used worldwide for the treatment of urinary incontinence. The aim of this study is to review the effectiveness, safety and complications of the TVT operation in human subjects.

Material and Methods: We searched Medline for the term “tension free vaginal tape” for the period from January 1994 - January 2003. Included are all articles in English, French and German.

Results: A total of 106 articles was found. The success rate was reported to be between 59 % and 100 %. Frequent complications were found in up to 60 % of patients and included: bladder perforation, urinary retention, urinary tract infection, de novo urge incontinence, de novo detrusor instability, bleeding, haematoma, pain. Rare complications described in up to 3.3 % of cases included: erosion of the vagina, urethra or bladder, vaginal lesion, urethral lesion, vessel injury, nerve injury, bowel injury, urethral fistula, vesicovaginal fistula, wound infection, defective wound healing, sling rejection, technical problems, venous thrombosis, acute renal failure, septicaemia, myocardial infarction, death.

Conclusion: TVT is a safe and effective method for the treatment of urinary incontinence, with good short-term and middle-term results. Due to the lack of standardisation in the studies with respect to inclusion criteria (stress urinary incontinence or mixed incontinence, TVT only or in combination with other operations, previous operations), definitions of outcome, study design (only 3 prospective randomised studies) as well as sample size (19 studies with < 50 patients), it is difficult to interpret the results.

Tension-free vaginal tape

Tension-free vaginal tape

Literatur

• 1 Ulmsten U, Henriksson L, Johnson P, Varhos G. An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence.  Int Urogynecol J. 1996;  7 81-86
• 2 DeLancey J OL. Structural support of the urethra as it relates to stress urinary incontinence: the hammock hypothesis.  Am J Obstet Gynecol. 1994;  170 1713-1723
• 3 Petros P, Ulmsten U. An integral theory on female urinary incontinence. Experimental and clinical considerations.  Acta Obstet Gynecol Scand. 1990;  69 (Suppl) 153
• 4 Haab F, Traxer O, Ciofu C. Tension-free vaginal tape: why an unusual concept is so successful.  Curr Opin Urol. 2001;  11 293-297
• 5 Nilsson C G, Kuuva N, Falconer C, Rezapour M, Ulmsten U. Long-term results of the tension-free vaginal tape (TVT) procedure for surgical treatment of female stress urinary incontinence.  Int Urogynecol J. 2001;  2 (Suppl) S5-S8
• 6 Ward K, Hilton P. Prospective multicentre randomised trial of tension-free vaginal tape and colposuspension as primary treatment for stress incontinence.  BMJ. 2002;  325 67
• 7 Liapis A, Bakas P, Creatsas G. Burch colposuspension and tension-free vaginal tape in the management of stress urinary incontinence in women.  Eur Urol. 2002;  41 469-473
• 8 Quievy A, Couturier F, Prudhon C, Abram F, Al Salti R, Ansieau J P. Comparaison économique de deux techniques chirurgicales de traitement de l'incontinence urinaire d'effort chez la femme: technique de Burch contre technique TVT.  Prog Urol. 2001;  11 347-353
• 9 Persson J, Teleman P, Etén-Bergquist C, Wølner-Hanssen P. Cost-analyzes based on a prospective, randomized study comparing laparoscopic colposuspension with a tension-free vaginal tape procedure.  Acta Obstet Gynecol Scand. 2002;  81 1066-1073
• 10 Liang C C, Soong Y K. Tension-free vaginal tape versus laparoscopic bladder neck suspension for stress urinary incontinence.  Chang Gung Med J. 2002;  25 360-366
• 11 Wang K H, Neimark M, Davila G W. Voiding dysfunction following TVT procedure.  Int Urogynecol J. 2002;  13 353-358
• 12 Moss E, Toozs-Hobson P, Cardozo L, Emens M, Pogmore J R, Constantine G. A multicentre review of the tension-free vaginal tape procedure in clinical practice.  J Obstet Gynaecol. 2002;  5 519-522
• 13 Bodelsson G, Henriksson L, Osser S, Stjernquist M. Short term complications of the tension free vaginal tape operation for stress urinary incontinence in women.  BJOG. 2002;  109 566-569
• 14 De Tayrac R, Kadoch I J, Gervaise A, Fernandez H. Chirurgie de l'incontinence urinaire d'effort par le TVT: le point de vue des patientes. Résultats d'une enquête postale chez 144 patientes avec un recul de 20 mois.  J Gynecol Obstet Biol Reprod (Paris). 2002;  31 162-166
• 15 Moran P A, Ward K L, Johnson D, Smirni W E, Hilton P, Bibby J. Tension-free vaginal tape for primary genuine stress incontinence: a two-centre follow-up study.  BJU Int. 2000;  86 39-42
• 16 Champetier D, Ruffion A, Lopez J G, Devonec M, Leriche A, Perrin P. Ajustement différé de la tension de matériel prothétique sous-urethral (TVT) après cure chirurgicale d'incontinence urinaire d'effort de la femme.  Prog Urol. 2001;  11 1314-1319
• 17 Lo T S, Horng S G, Chang C L, Huang H J, Tseng L H, Liang C C. Tension-free vaginal tape procedure after previous failure in incontinence surgery.  Urology. 2002;  60 57-61
• 18 Lo T S, Wang A C, Horng S G, Liang C C, Soong Y K. Ultrasonographic and urodynamic evaluation after tension free vagina tape procedure (TVT).  Acta Obstet Gynecol Scand. 2001;  80 65-70
• 19 Azam U, Frazer M I, Kozman E L, Ward K, Hilton P, Rane A. The tension-free vaginal tape procedure in women with previous failed stress incontinence surgery.  J Urol. 2001;  166 554-556
• 20 Rezapour M, Ulmsten U. Tension-free vaginal tape (TVT) in women with recurrent stress urinary incontinence - a long-term follow-up.  Int Urogynecol J Pelvic Floor Dysfunct. 2001;  2 (Suppl) S9-S11
• 21 Rezapour M, Ulmsten U. Tension-free vaginal tape (TVT) in women with mixed urinary incontinence - a long-term follow-up.  Int Urogynecol J Pelvic Floor Dysfunct. 2001;  2 (Suppl) S15-S18
• 22 Olsson I, Kroon U B. A three-year postoperative evaluation of tension-free vaginal tape.  Gynecol Obstet Invest. 1999;  48 267-269
• 23 Ulmsten U, Falconer C, Johnson P, Jomaa M, Lannér L, Nilsson C G, Olsson I. A multicenter study of tension-free vaginal tape (TVT) for surgical treatment of stress urinary incontinence.  Int Urogynecol J Pelvic Floor Dysfunct. 1998;  9 210-213
• 24 Nilsson C G, Kuuva N. The tension-free vaginal tape procedure is successful in the majority of women with indications for surgical treatment of urinary incontinence.  BJOG. 2001;  108 414-419
• 25 Jomaa M. Combined tension-free vaginal tape and prolapse repair under local anaesthesia in patients with symptoms of both urinary incontinence and prolapse.  Gynecol Obstet Invest. 2001;  51 184-186
• 26 Rezapour M, Falconer C, Ulmsten U. Tension-free vaginal tape (TVT) in stress incontinent women with intrinsic sphincter deficiency (ISD) - a long-term follow-up.  Int Urogynecol J Pelvic Floor Dysfunct. 2001;  2 (Suppl) S12-S14
• 27 Deval B, Jeffry L, Al Najjar F, Soriano D, Daraï E. Determinants of patient dissatisfaction after a tension-free vaginal tape procedure for urinary incontinence.  J Urol. 2002;  167 2093-2097
• 28 Ulmsten U, Johnson P, Rezapour M. A three-year follow-up of tension free vaginal tape for surgical treatment of female stress urinary incontinence.  Br J Obstet Gynaecol. 1999;  106 345-350
• 29 Jeffry L, Deval B, Birsan A, Soriano D, Daraï E. Objective and subjective cure rates after tension-free vaginal tape for treatment of urinary incontinence.  Urology. 2001;  58 702-706
• 30 Daraï E, Jeffry L, Deval B, Birsan A, Kadoch O, Soriano D. Results of tension-free vaginal tape in patients with or without vaginal hysterectomy.  Eur J Obstet Gynecol Reprod Biol. 2002;  10 (103) 163-167
• 31 Dingeldein I, Eggimann T, Dreher E, Kuhn A. Tension-free vaginal tape - Eine prospektive Evaluation.  Geburtsh Frauenheilk. 2002;  62 1081-1087
• 32 Heider R, Gründling H, Zegermacher G, Enzelsberger H. Zur Effizienz von “Tension free Vaginal Tape®” (TVT) als Therapie von Harnstressinkontinenz bei hypotoner Urethra.  Geburtsh Frauenheilk. 2002;  62 136-144
• 33 Groutz A, Gordon D, Wolman I, Jaffa A J, David M P, Lessing J B. Tension-free vaginal tape for stress urinary incontinence: is there a learning curve?.  Neurourol Urodyn. 2002;  21 470-472
• 34 Kuuva N, Nilsson C G. A nationwide analysis of complications associated with the tension-free vaginal tape (TVT) procedure.  Acta Obstet Gynecol Scand. 2002;  81 72-77
• 35 Lebret T, Lugagne P M, Hervé J M, Barré P, Orsoni J L, Yonneau L, Saporta F, Botto H. Evaluation of tension-free vaginal tape procedure. Its safety and efficacy in the treatment of female stress urinary incontinence during the learning phase.  Eur Urol. 2001;  40 543-547