title: [Repair of female urinary incontinence with prolene "TVT": preliminary results of a multicenter and prospective survey].
abstract: OBJECTIVE
  A multicentre, prospective study (6 private centres, 1 general hospital and 1 teaching hospital) was conducted to evaluate the perioperative morbidity and short-term functional results of the TVT procedure in the treatment of the female urinary stress incontinence.
  
  
  METHODS
  From November 1996 to September 1999, 120 patients with a mean age of 65.2 years (range: 37-91) were operated according to the tension-free vaginal tape (TVT) technique for isolated urinary stress incontinence (stage 2 or 3) in 94 cases and associated with pelvic tone disorder in 26 cases. 59 patients (49.2%) presented recurrence of urinary incontinence that had already been operated between 1 and 4 times. Physical examination demonstrated hypermobility of the urethra in 73 cases (60.8%), isolated clinical sphincter incompetence in 47 cases (39.2%) and pelvic tone disorders in 31 cases. Urodynamic studies, performed in 113 patients, demonstrated sphincter incompetence in 65 cases (57.5%) with a mean maximum urethral closure pressure of 18 cmH2O (range: 5-29).
  
  
  RESULTS
  The operation, performed under spinal anaesthesia in 97 cases (80.8%), general anaesthesia in 16 cases (13.3%) and local anaesthesia in 7 cases (5.8%) lasted an average of 28.7 min (range: 15-60) for insertion of the TVT. Perioperative complications consisted of twelve bladder injuries (10%) and two pelvic haematomas (1.7%). No cases of infection, erosion or migration of the tape were reported. In the group of 94 patients operated exclusively by TVT, the mean hospital stay was 2.6 days (range: 1-7). Twelve patients (10%) required self-catheterization for 2 to 30 days. With a mean follow-up of 15.2 months (range: 36-6), continence was restored in 104 patients, corresponding to a cure rate of 86.7%. A marked improvement was obtained in 11 cases (9.2%) and five cases (4.2%) were considered to be failures.
  
  
  CONCLUSIONS
  The TVT procedure is a new approach to the treatment of female urinary stress incontinence. Its advantages are its simplicity, the rapidity of the technical procedure and the short-term efficacy on continence. A longer follow-up is essential to assess to the functional outcome and the long-term urethral tolerance.
authors.affiliation: Service de Chirurgie Urologique et d'Andrologie, CHU de Rangueil, Toulouse, France. soulié.m@chu-toulouse.fr
authors.forename: M
authors.initials: M
authors.lastname: Soulié
authors.forename: F
authors.initials: F
authors.lastname: Delbert-Julhes
authors.forename: X
authors.initials: X
authors.lastname: Cuvillier
authors.forename: P
authors.initials: P
authors.lastname: Mouly
authors.forename: J
authors.initials: J
authors.lastname: Thanwerdas
authors.forename: P
authors.initials: P
authors.lastname: Dufeuil
authors.forename: J M
authors.initials: JM
authors.lastname: Larroque
authors.forename: J
authors.initials: J
authors.lastname: Bernstein
authors.forename: R
authors.initials: R
authors.lastname: Soulié
authors.forename: C
authors.initials: C
authors.lastname: Chemasle
authors.forename: P
authors.initials: P
authors.lastname: Brucher
authors.forename: N
authors.initials: N
authors.lastname: Vazzoler
authors.forename: P
authors.initials: P
authors.lastname: Seguin
authors.forename: F
authors.initials: F
authors.lastname: Pontonnier
authors.forename: P
authors.initials: P
authors.lastname: Plante
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D011126:Polypropylenes; D011446:Prospective Studies; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods
chemical_list: D011126:Polypropylenes