The tension-free vaginal tape procedure: correction of stress incontinence with minimal alteration in proximal urethral mobility

Objectives. To prospectively assess the degree of urethral hypermobility in the preoperative and postoperative periods after the tension-free vaginal tape (TVT) procedure and correlate our findings with surgical outcome. Methods. Twenty patients with stress incontinence underwent the TVT procedure. A Q-tip test was performed before the procedure and at the 3-week postoperative follow-up visit. Cure was defined as the absence of the subjective complaint of urine leakage and the absence of stress incontinence on stress testing at cystometric capacity. Results. Seventeen patients (85%) were cured by the TVT procedure, 2 patients (10%) were improved, and 1 patient (5%) was unchanged. The mean preoperative and postoperative Q-tip values were 42.75° and 31.75°, respectively. Twelve patients had a Q-tip test result of 30° or greater after surgery and 11 (92%) of these 12 patients were cured by the procedure. Conclusions. On the basis of these results, we propose that the cure of stress incontinence does not require the correction of proximal urethral hypermobility.