JOGC SEPTEMBER 2003 GYNAECOLOGY 1 Abstract Objective: To evaluate changes in urodynamic parameters, therapeutic success, and complication rates after a tension- free vaginal tape (TVT) procedure in women with stress urinary incontinence (SUI). Methods: Sixty-three women who underwent a TVT procedure for SUI, between June 1999 and December 2001 at Mount Sinai Hospital in Toronto, Ontario, were prospectively followed. Pre- and postoperative clinical data were analyzed using the Mann-Whitney, chi-square, paired t-test, and Wilcoxon signed ranks tests. Results: The range of follow-up was 6 weeks to 3 years. Short- term voiding dysfunction occurred in 49% of the women but was completely resolved in all women by the 12-week follow- up. For the 45 women who completed their follow-up at 6 months or 1 year after TVT, the success rate was 85%. Provocative urodynamics at 1-year follow-up compared to preoperative data showed a decrease in maximum flow rate (P < 0.001), and increase in post-void residual urine volume (P < 0.001). Conclusion: TVT is associated with a good short-term success rate at 6 months and 1 year. A low long-term complication rate and morbidity may be expected, but significant temporary voiding dysfunction, higher than previously reported, was observed. Résumé Tk J Obstet Gynaecol Can 2003;25(9):xxx–xx. INTRODUCTION More than 100 different surgical procedures have been described in the literature for the treatment of stress urinary incontinence (SUI). 1 Open retropubic urethropexy remains one of the most researched and most successful operations, with 10- to 20-year success rates of 69% to 94%. 1-5 Tension-free vaginal tape (TVT) was first described in 1996 by Ulmsten et al. 6 as a simple, minimally invasive day- case procedure under local or regional anaesthesia. It was devel- oped to correct SUI due to urethral sphincter incompetence and has the added benefit that the tension of the tape can be V OIDING P ATTERNS AND URODYNAMICS AFTER A TENSION-FREE V AGINAL T APE PROCEDURE Key Words Female urinary incontinence, stress urinary incontinence, urodynamics, tension-free vaginal tape, postoperative voiding dysfunction Competing interests: Dr Drutz is on the advisory board of Gynecare (manufacturers of Gynecare TVT Tension-Free Support for Incontinence), a division of Ethicon, a Johnson & Johnson company. Received on February 10, 2003 Revised and accepted on April 2, 2003 Ahmed Al-Badr, MBBS, FRCSC, 1,4 Sue Ross, PhD, 2 Dana Soroka, MD, FRCSC, 3 Vatche A. Minassian, MD, 1 Amalia Karahalios, 2 Harold P. Drutz, MD, FRCSC 1 1 Division of Urogynaecology, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto,Toronto ON 2 Maternal, Infant and Reproductive Health Research Unit, Centre for Women’s Health, Sunnybrook and Women’s College Health Sciences Centre, and Department of Health Policy,Management and Evaluation,University of Toronto,Toronto ON 3 Department of Obstetrics and Gynaecology,Saint Michael’s Hospital,University of Toronto,Toronto ON 4 Department of Obstetrics and Gynecology, Security Forces Hospital, Riyadh, Saudi Arabia 2nd revision August 13