Tension-free vaginal tape versus laparoscopic bladder neck suspension for stress urinary incontinence.
BACKGROUND
Owing to their various advantages, including shortened hospital stays, faster recoveries, and satisfactory outcomes, laparoscopic bladder neck suspension (LBNS) and tension-free vaginal tape (TVT) have become 2 well-known minimally-invasive anti-incontinent procedures. The aim of this study was to demonstrate the outcomes of LBNS and TVT procedures for treatment of stress urinary incontinence.


METHODS
From October 1997 to February 2000, 22 women with genuine stress incontinence underwent LBNS, and another 23 women underwent TVT. Estimates of operative time, blood loss, and time to resumption of spontaneous urination were recorded for each group. Surgical results were assessed by urodynamic studies, 1-h pad tests, and voiding diaries.


RESULTS
There were no statistically significant differences between these 2 groups in terms of demographics and blood loss during the operation. When comparing operative time and time to resumption of spontaneous urination, the TVT group had significantly lower values than did the LBNS group for both parameters, at 31.9+/-6.0 vs. 111.7+/-15.6 min and 2.1+/-1.5 vs. 4.0+/-0.9 days, respectively. The cure rate was 86.9% in the TVT group and 86.4% in the LBNS group.


CONCLUSIONS
Both TVT and LBNS have been proven effective in treating women with stress urinary incontinence. The TVT procedure, owing to its shorter learning curve, less intraoperative blood loss, and quicker resumption of spontaneous urination, is recommended to treat women suffering from pure stress urinary incontinence. Whereas, in cases that are complicated with concomitant adnexal disease or uterine pathology, LBNS is considered an alternative procedure.
Liang
Ching-Chung
CC
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taipei, Taiwan, ROC. ccjoliang@cgmh.org.tw
Soong
Yung-Kuei
YK
D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D001743:Urinary Bladder / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014621:Vagina / Q000601:surgery*