Association Between Preoperative Pelvic Floor Muscle Strength and Outcomes of TVT-O Surgery for Stress Urinary Incontinence: A Retrospective Cohort Study.
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Abstract
Introduction and hypothesis: This study aimed to investigate the relationship between preoperative pelvic floor muscle (PFM) strength and the efficacy of tension-free vaginal tape-obturator (TVT-O) surgery in women with stress urinary incontinence (SUI).
Methods: Two hundred women diagnosed with SUI who underwent TVT-O surgery were included. PFM strength was assessed preoperatively using a validated digital palpation method. The evaluation of the effectiveness of surgical treatments for SUI was based on standardized criteria for urine leakage during stress conditions, changes in the 1-h pad test urine volume compared to preoperative levels, and the postoperative IIQ-7 scores. Patients were classified into "improved" and "unimproved" groups. Univariate and multivariate logistic regression models were used to analyze the association between PFM strength and postoperative improvement.
Results: A total of 170 patients were categorized as the improved group, while 30 patients were classified in the unimproved group. The improved group demonstrated a mean PFM strength of 3.5 ± 1.4 cmH2O vs. 2.8 ± 1.2 cmH2O (p < 0.01). In both univariate and multivariate logistic regression analyses, PFM strength was significantly associated with postoperative improvement, with odds ratios of 2.8 (95% CI 1.4 to 5.5, p = 0.004) and 2.5 (95% CI 1.2 to 5.0, p = 0.01), respectively. Subgroup analyses revealed that the association was particularly strong in postmenopausal women, multiparous patients, and those with comorbidities.
Conclusion: Preoperative PFM strength is significantly associated with the efficacy of TVT-O surgery for SUI. This study highlights the importance of PFM strength in predicting surgical outcomes and suggests that preoperative assessment of PFM strength may help in optimizing patient selection for SUI patients undergoing TVT-O.
期刊介绍：
The International Urogynecology Journal is the official journal of the International Urogynecological Association (IUGA).The International Urogynecology Journal has evolved in response to a perceived need amongst the clinicians, scientists, and researchers active in the field of urogynecology and pelvic floor disorders. Gynecologists, urologists, physiotherapists, nurses and basic scientists require regular means of communication within this field of pelvic floor dysfunction to express new ideas and research, and to review clinical practice in the diagnosis and treatment of women with disorders of the pelvic floor. This Journal has adopted the peer review process for all original contributions and will maintain high standards with regard to the research published therein. The clinical approach to urogynecology and pelvic floor disorders will be emphasized with each issue containing clinically relevant material that will be immediately applicable for clinical medicine. This publication covers all aspects of the field in an interdisciplinary fashion
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