Predictive factors of bladder outlet obstruction following the tension-free vaginal tape obturator (TVTO) procedure in females treated surgically for stress urinary incontinence

To identify patients at risk for postoperative outlet obstruction after the tension-free vaginal tape obturator (TVTO) procedure in order to allow for better counseling and possible treatment alternatives. This prospective study was carried out on 85 women who underwent the TVTO procedure for treatment of stress urinary incontinence (SUI). Preoperatively, a detailed medical history was taken from all patients, and all were subjected to physical examination, routine labs, abdominal and pelvic ultrasound and urodynamic studies (cystometry and assessment of the detrusor leak point pressure (DLPP), abdominal leak point pressure (ALPP), pressure flow and post-void residual (PVR) urine). The TVTO procedure was carried out by the same surgeon in all cases. Postoperative voiding dysfunction in this study was defined as the subjective feeling of difficult voiding, a weak stream and/or incomplete evacuation, and a PVR urine volume >100ml, a urine flow rate