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Q-Tip Test and Tension-Free Vaginal Tape in the Management of Female Patients with Genuine Stress Incontinence

2002; Karger Publishers; Volume: 53; Issue: 3 Linguagem: Inglês

10.1159/000058369

1423-002X

Panagiotis Bakas, Angelos Liapis, G. Creatsas,

Hernia repair and management

To compare the Q-tip test before and after performance of the tension-free vaginal tape (TVT) procedure in women with genuine stress incontinence, and to determine the value of the Q-tip test in order to predict the outcome of TVT.Thirty-one patients with a diagnosis of stress incontinence but without previous anti-incontinence surgery (group I) and 10 patients with stress incontinence and a history of previous anti-incontinence surgery (group II) participated in the study. None of these patients had an anterior vaginal wall prolapse of greater than stage I according to the International Continence Society Classification and, therefore, the TVT procedure was the only operation performed on these patients. Urethral mobility using the Q-tip test was assessed by the same examiner at the initial physical examination and at the 6-month follow-up examination. Cure was defined as no leakage of urine postoperatively either subjectively or objectively, while failure was defined the objective loss of urine during the stress test.The mean preoperative and postoperative Q-tip measurement in patients without previous operation (group I) was 43.5 +/- 5.84 and 33.38 +/- 4.77 degrees, respectively (mean difference 10.12 degrees), while the cure rate was 87.1%. The mean preoperative and postoperative Q-tip measurement in patients with previous operation (group II) was 17.5 +/- 4.44, and 11.1 +/- 6.88 degrees, respectively (mean difference 6.4 degrees), while the cure rate was 40%.Adequate mobility of the proximal urethra is associated with a high success rate of the TVT procedure.