Preoperative urodynamic predictors of short-term voiding dysfunction following a transobturator tension-free vaginal tape procedure

Objective: To determine whether preoperative urodynamic parameters can predict the development of short-term voiding dysfunction (VD) after a transobturator tension-free vaginal tape (TO-TVT) procedure. Methods: In a prospective study between April 2005 and April 2007, 341 women were randomized to receive "inside-out" or "outside-in" TO-TVT. The present secondary analysis included women who had completed a preoperative symptom questionnaire, had a voided volume of 100 mL or more on preoperative uroflowmetry, and underwent standardized postoperative voiding assessment. VD was defined as a requirement for postoperative catheterization. Univariate and multivariate analysis were done by SPSS 17. Results: The inclusion criteria were met by 224 women, of whom 17 (7.6%) had postoperative VD. On univariate analysis, there were no differences in preoperative parameters among those with and those without VD: residual urine volume (P = 0.485), peak flow rate on or below 5th centile (P = 0.272), average flow rate on or below 5th centile (P = 0.142), detrusor pressure at opening (P = 0.955), maximum urethral closure pressure at 30 cm H2O or less (P = 0.855) and functional urethral length (P = 0.173). None of the variables analyzed was an independent risk factor on multivariate analysis. Conclusion: Preoperative urodynamic parameters did not predict the development of short-term voiding dysfunction after a TO-TVT procedure.