Platinum Priority – Female Urology – Incontinence Editorial by Firouz Daneshgari on pp. 947–948 of this issue Tension-free Vaginal Tape for the Treatment of Urodynamic Stress Incontinence: Efficacy and Adverse Effects at 10-Year Follow-Up Maurizio Serati a, *, Fabio Ghezzi a , Elena Cattoni a , Andrea Braga a , Gabriele Siesto b , Marco Torella c , Antonella Cromi a , Domenico Vitobello b , Stefano Salvatore d a Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy; b Department of Gynecology, IRCCS Humanitas Clinical Institute, Rozzano, Milan, Italy; c Department of Obstetrics and Gynecology, 2nd Faculty, Naples, Italy; d Department of Obstetrics and Gynecology, IRCCS San Raffaele Hospital, Milan, Italy EUROPEAN UROLOGY 61 (2012) 939–946 available at www.sciencedirect.com journal homepage: www.europeanurology.com Article info Article history: Accepted January 18, 2012 Published online ahead of print on January 26, 2012 Keywords: Stress urinary incontinence (SUI) Tension-free vaginal tape (TVT) Urodynamic stress incontinence (USI) Long-term follow-up Urinary incontinence (UI) Overactive bladder (OAB) Abstract Background: One of the most effective and popular current procedures for the surgical treatment of stress urinary incontinence (SUI) is tension-free midurethral slings. Objective: To evaluate the outcomes of women with retropubic tension-free vaginal tape (TVT) for urodynamic stress incontinence (USI) after 10-yr follow-up. Design, setting, and participants: This was a prospective observational study. Consecu- tive women with proven USI were treated with TVT. Patients with mixed incontinence and/or anatomic evidence of pelvic organ prolapse were excluded. Intervention: Standard retropubic TVT. Measurements: Patients underwent preoperative clinical and urodynamic evaluations. During follow-up examinations, women were assessed for subjective satisfaction and objective cure rates. Multivariable analyses were performed to investigate outcomes. Results and limitations: A total of 63 women were included. After 10 yr, 5 patients (8%) were lost or no longer evaluable. The 10-yr subjective, objective, and urodynamic cure rates were 89.7%, 93.1%, and 91.4%, respectively. These rates were stable across the whole study period ( p > 0.99). De novo overactive bladder was reported by 30.1% and 18.9% of patients at 3-mo and 10-yr follow-up, respectively ( p for trend = 0.19). A total of 84.2% of women with detrusor overactivity received antimuscarinic drugs, but 43.8% were nonresponders 12 wk later. At multivariable analysis, maximum detrusor pressure during the filling phase >9 cm H 2 O (hazard ratio [HR]: 16.2; p = 0.01) and maximum detrusor pressure during the voiding phase 29 cm H 2 O (HR: 8.0; p = 0.01) were independent predictors for the recurrence of SUI, as well as obesity was for the recurrence of objective SUI (HR: 17.1; p = 0.01) and of USI (HR: 8.9; p = 0.02), respec- tively. Intraoperatively, bladder perforation occurred in two cases; no severe bleeding or other complications occurred. Conclusions: The 10-yr results of this study seem to demonstrate that TVT is a highly effective option for the treatment of female SUI, recording a very high cure rate with low complications after a 10-yr follow-up. # 2012 European Association of Urology. Published by Elsevier B.V. All rights reserved. * Corresponding author. Department of Obstetrics and Gynecology, Urogynecology Unit, University of Insubria, Piazza Biroldi 1, 21100 Varese, Italy. Tel. +39 0332 299 309; Fax: +39 0332 299 307. E-mail address: mauserati@hotmail.com (M. Serati). 0302-2838/$ – see back matter # 2012 European Association of Urology. Published by Elsevier B.V. All rights reserved. doi:10.1016/j.eururo.2012.01.038