Is the cough test necessary at TVT insertion? A case control series
HP Dietz, C Barry, A Rane, PD Wilson
The tension-free vaginal tape (TVT) was originally described using a cough test for tape adjustment. More recently, the usefulness of this technique has been questioned and the authors performed a case control series to address this issue. Patients after TVT performed with (n=52) or without cough test (n=54) were invited for review. Matching of the groups was undertaken for age, pre-existing urge incontinence, preoperative maximum flow rate (MFR) centile, concomitant anterior repair and length of follow up. There were no significant differences between groups for subjective cure, satisfaction, subjective symptoms of incontinence, frequency or nocturia. There were more symptoms of voiding dysfunction after cough test (p=0.019). Postoperative flowmetry did not differ significantly, but ultrasound data indicate that the cough test results in a tighter tape. In conclusion, avoiding the cough test seems to have no negative effect on patient satisfaction or subjective symptoms of stress incontinence in the short-term.