Treatment of Female Stress Urinary Incontinence by Trans-Obturaror Tension-Free Vaginal Tape (TVT-O): A Prospecive Controlled Study,
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- Category: Vol. 79, June 2011
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Treatment of Female Stress Urinary Incontinence by Trans-Obturaror Tension-Free Vaginal Tape (TVT-O): A Prospecive Controlled Study,MAHMOUD M. OSMAN and TAREK R. ABBAS
Abstract
Objectives: To evaluate the results of TVT-O procedure in women with stress urinary incontinence, with cough test performed in theatre.
Patients and Methods: Thirty seven women aged 35-65 years attending the Gynecology Clinic at two centers from April/2006 - April/2009, were recruited in the present study.
Results: The study addresses the intraoperative, immediate and medium term postoperative complications and cure rate after TVT-O procedures in absence and presence of intrinsic sphincter deficiency (ISD). In this study, 27 TVT-O procedures were performed successfully under local anesthesia and sedation, and in 10 patients we needed to give spinal anesthesia and sedation according to the request of the patient. Bladder perforation occurred in one patient (2.7%) and short postop-erative urine retention occurred in two patients (5.4%). The short term complications included groin pain in three women (8.1%) which completely resolved by 6 weeks post surgery. The patients who had their surgery in the morning discharged on the same day (within 10 hours), except one patient who discharged the following day, the delay in her discharge was planned preoperatively due to her medical history. There were only two women (5.4%) with intermediate long term compli-cations who developed pain in the vagina that required excision of a small part of the tape. This did not affect her cure from SUI. Three women (8.1%) developed mild urinary urgency that did not require any further management. Nine women (24.3%) in the study had ISD with or without hypermobile bladder neck and six out of them had maximum urethral closure pressure less than 20cm H2O. All the 37 women (with and without ISD) were cured from SUI in their last follow-up (average 16.2 weeks).
Conclusion: The TVT-O procedure is a safe and efficient treatment of female stress urinary incontinence, with mainte-nance of high cure rate.