Objective. To discuss the practical value of the cough test during the tension-free vaginal tape (TVT) procedure. Methods. In the first group, 41 patients of female stress incontinence received TVT operations which were performed according to the Ulmsten’s method strictly, only that the stress of tape was adjusted in light of the cough test. In the second group, 44 patients of female stress incontinence received TVT operations in which the tape was put under the urethral tract without stress, not adjusted by cough test. Results. The cure rate was 38/41 (92.6%) in the cough test group and 41/44 (93.1%) in the noncough test group; detrusor pressure-uroflow study indicated that there were 11 cases in the obstruction zone in the cough test group while only 3 cases were in the obstruction zone in the noncough test group; 4 cases of urinary retention and 5 cases of voiding dysfunction were found in the cough test group, while difficulties of urination were not found in the non-cough test group. Conclusion. Adjusting the tape stress in accordance with the cough test during the TVT can increase the opportunity of urinary retention or difficulty of urination after operation. So there is no benefit of the cough test during tension-free vaginal tape procedure in preventing post-operative urinary retention. 1. Introduction DeLancey [1] proposed a theory to explain the mechanistic basis of female stress incontinence in 1994. In his view, the increase in the abdominal pressure during cough in healthy females led to elevated urethral closure pressure and prevented leakage from the urethra. Compression of urethra on its underlying hammock-like supportive tissues was the main reason for the increase of urethral closure pressure; therefore, focus should be placed upon reconstruction of the supportive tissues under the urethra in the treatment of female stress urinary incontinence. On the basis of this theory, Ulmsten et al. [2] firstly designed and reported a method of using tension-free vaginal tape (TVT) procedure for the treatment of female stress urinary incontinence. Because of its minimal injury, short hospital stay, and high cure rate, this procedure has been widely adopted. According to the latest statistics, approximately 68% of female patients with stress incontinence were treated by this operation [3]. Urinary retention and dysuria are the most common complications after TVT. The rate of voiding dysfunction following the TVT procedure has been reported to be between 4% and 10%, and that is between 2% and 43% for urinary retention. Tape adjustment during TVT
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