Voiding difficulty and other adverse events after tension free vaginal tape

The object of the study was to assess voiding difficulty, bacterial cystitis, de-novo urge incontinence and other adverse events after tension free vaginal tape (TVT) procedures. A consecutive series of 62 cases were assessed (48 TVT-alone and 14 combined with prolapse surgery). Pre- and post-operative uroflowmetry and residual urine volumes were recorded. Strict definitions of normal voiding function were employed. Adverse events were recorded in the immediate post-operative period and at the 6 week outpatient review. As defined, immediate voiding difficulty occurred in 25% of TVT-alone cases and 50% of TVT-combined procedures (31% overall). At 6 weeks, residual urine volumes were significantly increased in both the TVT-alone and combined groups, but voiding difficulty resolved in all but 8% and 28% cases respectively. Proven bacterial cystitis was observed in 11% of cases at 6 weeks and de-novo urge incontinence occurred in 10% of women. In conclusion, previous published series of the TVT procedure have emphasised efficacy but not focused upon adverse events. Patients and family doctors need to be made aware that such adverse events may occur, particularly in view of the short hospital stay that is recommended for this procedure.