title: [Outpatient surgical treatment of female stress urinary incontinence].
abstract: OBJECTIVE
  To evaluate the results of the outpatient surgical treatment of genuine female stress urinary incontinence (SUI) over a five year period since the integration of the Department of Urology in the Ambulatory Surgery Unit at our hospital "Consorcio Hospital General Universitario de Valencia" (CHGUV).
  
  
  METHODS
  Between January 2000 and December 2004 26 patients (ages 49-78; mean age 69.8 yr) with the diagnosis of SUI underwent tension-free suburethral mesh sling (TVT) outpatient operations under local anesthesia-sedation at the ambulatory surgery unit of the CHGUV. All patients had clinical and urodynamic evaluation, excluding those presenting genital prolapse or non compliance with the social requirements for ambulatory surgery. Previous anti-incontinence surgery was not an exclusion criterion. We evaluate inclusion and discharge criteria, results and satisfaction degree measured by a questionnaire.
  
  
  RESULTS
  22 patients (85%) had genuine SUI and 4 (15%) had mixed UI with predominance of the stress component. 54% (14) of the patients were ASA I, 31% (8) ASA II, and 15% (4) well compensated ASA III. Operation tolerance under local anesthesia (20-30 ml 1% lidocaine) was good in all patients, having used additional sedation-analgesia (propofol-remifentanil IV perfusion) in 10 of them (38%). Mean operative time was 30 minutes (25-45) and stay at the unit discharge was 100 min. (80-140). All patients were discharged the same day. None of them required readmission or presented urinary retention after catheter removal. SUI disappeared in all of them. Three patients presented postoperative urge incontinence responsive to oral anticolinergic drugs. Our results are similar to those obtained with epidural anesthesia and hospital admission, being the degree of satisfaction with treatment higher than 95%.
  
  
  CONCLUSIONS
  The development of new, revolutionary systems for the treatment of SUI has simplified the surgical treatment of this entity, so that we can say a high percentage of patients may be included in an ambulatory surgery program, significantly improving cost-efficacy without diminishment of health-care quality or patient satisfaction.
authors.affiliation: Servicio de Urología, Consorcio Hospital General Universitario Valencia, España. pedronavalon@yahoo.com
authors.forename: Pedro
authors.initials: P
authors.lastname: Navalón Verdejo
authors.forename: Cristóbal
authors.initials: C
authors.lastname: Zaragozá Fernández
authors.forename: Felipe
authors.initials: F
authors.lastname: Ordoño Domínguez
authors.forename: Francisco
authors.initials: F
authors.lastname: Sánchez Ballester
authors.forename: Joaquín
authors.initials: J
authors.lastname: Juan Escudero
authors.forename: Milagros
authors.initials: M
authors.lastname: Fabuel Deltoro
authors.forename: Luis
authors.initials: L
authors.lastname: De la Torre Abril
authors.forename: Emilio
authors.initials: E
authors.lastname: López Alcina
mesh_terms: D000368:Aged; D000556:Ambulatory Surgical Procedures; D005260:Female; D006801:Humans; D008875:Middle Aged; D014550:Urinary Incontinence, Stress / Q000601:surgery*