[Analysis of complications of the tension-free vaginal tape procedure for surgical treatment of female stress urinary incontinence].
OBJECTIVE
The most common types of urinary incontinence in women are stress, urge and mixed incontinence. Stress urinary incontinence may be caused by an urethral hypermobility and internal sphincter deficiency (ISD). There are over 100 different surgical procedure for the treatment of female stress incontinence. Tension-free vaginal tape (TVT) is a new anti-incontinence surgical technique which was first described by Ulmsten in 1996. The aim of the study was to evaluate the complications of tension-free vaginal tape (TVT) for the surgical treatment of female stress incontinence.


METHODS
The study group was consisted of 162 women, aged 32-84. All patients had a basic evaluation that included a history, frequency/volume chart, questionnaire of micturition (self-made), physical examination, stress test, Bonney test, urinalysis and bacterial culture of urine. Women with mixed urinary incontinence and who underwent surgical treatment of SUI in the past had been done urodynamic investigation. The operation was carried out under epidural, subarachnoid and general anesthesia. The TVT procedure was performed as described by Ulmsten. The follow-up was done after 1 day, 1 and 3 and 6 months since the operation.


RESULTS
Among complications related to the procedure were 11 cases of cystotomy, 5 cases of urinary retention requiring four days catheterization, 3 cases of bleeding from the vagina, 14 cases of detrusor instability de novo. In 4 cases occurred postoperative obstinate pain. In 4 cases occurred recurrent urinary tract infection. None complication required invasive treatment. No evidence of defect healing or rejection of the tape was found.


CONCLUSIONS
We conclude that the TVT procedure is safe method of the surgical treatment of urinary stress incontinence associated with a low complications.
Broś
Magdalena
M
II Katedry i Kliniki Połoznictwa i Ginekologii AM w Warszawie.
Czajkowski
Krzysztof
K
Kornacki
Piotr
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects; D011126:Polypropylenes / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000209:etiology; D013526:Surgical Mesh / Q000706:statistics & numerical data*; D013997:Time Factors; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods
D011126:Polypropylenes