Clinical trials. In view of the problems involved in carrying out randomised controlled trials, given the rapid development of the technology, a cohort study should be conducted in a representative sample of patients undergoing TVT with annual follow-up over a period of 5 years.
Development of indications. TVT seems to be an effective, safe and reproducible first-choice surgical treatment for isolated SUI and, in this indication, it is gradually replacing BCS. But it has also been proposed in indications that have not yet been validated (recurrence after traditional surgery for incontinence, presence of sphincter insufficiency or of mixed incontinence, combination of TVT and treatment for prolapse), which means that a further assessment is needed in 1 or 2 years' time.
Standardisation of practice and costs. Data obtained from the PMSI (French computerised medical information system program) reveals discrepancies in how TVT is coded by different hospitals. Standardising practice would make it possible to interpret the diffusion of the method more accurately. Recognition of the method as a separate entity would also permit better management of the extra cost generated within hospital departments.