Is the cough-stress test necessary when placing the tension-free vaginal tape?

Miles Murphy, Patrick J. Culligan, Cristina M. Arce, Carol A. Graham, Linda Blackwell, Michael H. Heit

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


OBJECTIVE: To estimate whether the mode of anesthesia (and the resultant ability or inability to perform the cough-stress test) used during the tension-free vaginal tape (TVT) procedure affects postoperative continence. METHODS: A cohort of 170 women who underwent the TVT procedure without any other concomitant surgery completed the short form of the Urogenital Distress Inventory (UDI-6) to assess their continence status preoperatively and postoperatively. Chi-squared, t, and Mann-Whitney U tests were used to determine the association between these data and anesthesia type during univariate analysis. RESULTS: Both anesthesia groups showed significant improvement from their preoperative UDI-6 scores to their postoperative scores. However, when comparing the change from pre- to postoperative UDI-Stress Symptoms subscale scores between the 2 groups, we found a significant difference. Mean improvement in the local group was 58.3 (± 33.8) compared with 41.7 (± 39.4) in the general group (P = .02). CONCLUSION. Women who undergo TVT show significant improvements in incontinence severity regardless of anesthesia type. However, greater improvements in stress incontinence, as measured by the UDI-Stress Symptoms subscale, are seen when the TVT is placed while using the cough-stress test under local analgesia.

Original languageEnglish (US)
Pages (from-to)319-324
Number of pages6
JournalObstetrics and gynecology
Issue number2
StatePublished - Feb 2005

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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