[Ideas to make the TVT progress].
Because of the bladder injuries risk and subsequent increase of the intervention time due to the bladder integrity checking, many surgeons have abandoned TVT. Based on a demonstrative clinical case, we report a simple, fast and effective method meant to minimize the risk of bladder injuries and to wonder about the mandatory bladder checking by cystoscopy during the TVT sling installation. An infiltration of 1% Xylocaïne half diluted is carried out in the area laterally to the urethra and the bladder, through vaginal and pubic ways. A 360 ml blue of methylene solution bladder filling may show quickly and safely a bladder injuries occurrence, either a true transfixion or an under mucous route. Using this procedure, TVT technique could be no more dangerous or longer than the TOT technique.
Clinique Gynécologique et Obstétricale, Hôpital Charles-Nicolle, CHU de Rouen, pavillon Mère-Enfant, 1, rue de Germont, 76031, Rouen cedex, France.
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Friédérich
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Sergent
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Marpeau
D003558:Cystoscopy; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D008875:Middle Aged; D001743:Urinary Bladder / Q000293:injuries; D014549:Urinary Incontinence / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*