The impact of stress urinary incontinence procedures on bladder and voiding function: A comparison between Tension-free Vaginal Tape (TVT), autologous fascial sling (AFS) and Burch colposuspension (BC)

Introduction

Stress urinary incontinence (SUI) is common, affecting one-third of women [1,2]. The impact of SUI surgery on overactive bladder symptoms (OAB) is poorly understood. This study aims to evaluate the effect of SUI surgeries on bladder and voiding function.

Materials and methods

A retrospective study of 100 women who underwent SUI surgery at a UK tertiary centre was conducted. Pre-operative and post-operative bladder function was assessed using validated pelvic floor questionnaires, Electronic Personal Assessment Questionnaire(ePAQ). Five domains were analysed: pain and sensation, voiding, stress incontinence, OAB, and quality of life (QoL). Domain scores were calculated and change in scores analysed using paired T-test. A one-way analysis of variance (ANOVA) was used to compare results.

Results

The mean age of women was 51 years.

Post-operative analysis using paired T-tests showed significant improvement in stress incontinence and quality of life(p < 0.05). OAB symptoms improved significantly following all three procedures(p < 0.05). Voiding dysfunction improved significantly following AFS surgery(p < 0.05), with non-significant improvements noted in the TVT and Burch colposuspension cohorts (p = 0.47, 0.2 respectively).

The ANOVA test revealed a statistically significant difference in OAB symptoms based on the type of surgery (p = 0.013) in favour of TVT but no significant difference in other domains (p > 0.05).

Conclusion

This study demonstrates that all three SUI procedures significantly improve stress incontinence and QoL. OAB symptoms improved in all three groups; however, the type of surgery did have a statistically significant impact on symptoms. This can aid clinicians in effective patient counselling. Further research is warranted to analyse this further.