Tension-free vaginal tape in the elderly: is it a safe procedure?

Urology. 2005 Mar;65(3):479-82. doi: 10.1016/j.urology.2004.09.059.


Objectives: To analyze the safety and efficacy of tension-free vaginal tape (TVT) surgery in elderly versus younger women with stress urinary incontinence (SUI).

Methods: A total of 157 consecutive elderly women, aged 70 years and older, and 303 younger women (mean age, 74.8 and 57.2 years, respectively) who underwent TVT for urodynamically-confirmed SUI were prospectively enrolled. Concomitant genitourinary prolapse repair was performed in 84% of the elderly and 67% of the younger women. The main outcome measures were perioperative morbidity, postoperative SUI, persistent or de novo urge incontinence, and voiding dysfunction.

Results: The incidence of TVT-related morbidity was similar in both groups, except for significantly fewer cases of bladder perforation among elderly women (1.3% versus 4.9%, P <0.05). However, some age-related morbidity was noted among the elderly women: 2 cases of pulmonary embolism, 2 cases of cardiac arrhythmia, 1 case of severe pneumonia, and 1 case of deep vein thrombosis. The outcome analysis was restricted to 123 elderly and 208 younger women with follow-up of at least 12 months (mean, 30 +/- 12 months; range, 12 to 67 months). The incidence of persistent postoperative SUI and persistent urge incontinence was similar in both age groups. However, de novo urge incontinence was significantly more common among elderly women (18% versus 4%, P <0.05). Two elderly and three younger women had postoperative pressure-flow studies suggestive of bladder outlet obstruction.

Conclusions: Tension-free vaginal tape surgery in elderly women is associated with good outcome results; however, the risk of postoperative de novo urge incontinence, as well as age-related morbidity, is increased.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Female
  • Humans
  • Middle Aged
  • Prospective Studies
  • Prostheses and Implants / adverse effects*
  • Urinary Incontinence, Stress / surgery*
  • Urologic Surgical Procedures / adverse effects