title: Needle tip control and its effect in reducing intraoperative complications during tension-free vaginal tape placement.
abstract: Tactile needle tip control was used to aid perforation during standard tension-free vaginal tape (TVT) placement to treat urinary incontinence. The success and complications of this novel method were compared retrospectively with the reported results of the standard technique. One hundred nine patients had TVT placement between 1998 and 2001, with follow-up continuing into 2002. Preoperatively, the severity of urinary incontinence was assessed objectively. Postoperatively, TVT effectiveness was assessed subjectively by standardized questionnaire, completed by 78 of the 109 patients (72%). Objective 2-year rates for continence or improvement and most complication rates were similar to previously reported results. Needle tip control was helpful in lowering the occurrence of bladder perforation. Longer postoperative recovery times associated with postoperative dysuria or obstruction did not decrease patient satisfaction if the patient experienced a marked improvement in leakage.
authors.affiliation: Section of Gynecologic Surgery, Mayo Clinic, 200 First Street SW, Rochester, Minnesota, MN 55905, USA. croak.andrew@mayo.edu
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Croak
authors.forename: Valerie
authors.initials: V
authors.lastname: Schulte
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Klingele
authors.forename: John B
authors.initials: JB
authors.lastname: Gebhart
authors.forename: Raymond A
authors.initials: RA
authors.lastname: Lee
authors.forename: Timothy G
authors.initials: TG
authors.lastname: Lesnick
authors.forename: Salvador
authors.initials: S
authors.lastname: Peron
mesh_terms: D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control*; D019736:Prostheses and Implants; D001743:Urinary Bladder / Q000293:injuries*; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000628:therapy*; D014563:Urodynamics