The Austrian Tension-Free Vaginal Tape Registry: An Update
            Drs. K. Tamussino, E. Hanzal, D. Kolle, G. Ralph, P. Riss
            The Austrian Urogynecology Working Group
            Graz, Austria

Objective:  By May 2001 almost 7000 tension-free vaginal tape (TVT) sets had been sold in Austria. We assessed the use of and perioperative complications associated with the TVT operation with a central registry.
Methods:  55 gynecology units completed questionnaires on 2795 patients undergoing the TVT operation. Information was collected on patient, surgical and postoperative data.
Results:  Overall, 773 patients (28%) had undergone previous surgery for incontinence or prolapse. 1640 (59%) TVTs were performed as isolated operations. Of the isolated TVTs, 727 (44%) were performed with local, 711 (43%) with regional, and 193 (12%) with general anesthesia. In patients undergoing TVT only, postop. bladder drainage was with intermittent catheterization in 389 (24%) patients, an indwelling urethral catheter in 1032 (63%), and a suprapubic catheter in 143 (9%). The bladder perforation rate was 2.7% overall (n = 75) and higher in patients with previous surgery (4.4% vs. 2.0%, P = 0.01). There were 4 perforations (3.3%) among the 120 patients with previous colposuspension. Most patients undergoing TVT only were able to void the next day (range, 0 - >64). A total of 68 patients (2.4%) required reoperation for reasons related to the tape (39 to loosen, remove or cut the tape or to place a suprapubic catheter, 19 for hematoma, 1 for bowel injury).
Conclusion:  There are considerable variations in how the TVT operation is performed in clinical practice, particularly with regard to anesthesia and postoperative bladder drainage. The risk of bladder perforation was increased in patients with previous surgery. Severe complications were rare.
Key Words: Stress incontinence, tension-free vaginal tape