[Comparative study of the LIFT and the TVT procedure in the surgical treatment of female stress urinary incontinence].
OBJECTIVE
The purpose of the study was to compare a polyester mesh coated with silicone (LIFT, Cousin) to a polypropylene mesh (TVT, Gynecare), in terms of results, and short and middle term complications.


METHODS
We have performed a retrospective study concerning 140 patients between 2000 and 2002 (71 LIFT and 69 TVT operated for stress incontinence with or without vaginal surgery (prolapse surgery or hysterectomy). We noticed per- and postoperative complications. The patients were contacted by phone to evaluate the middle and long-term results.


RESULTS
The mean age of the patients were of 58.8+/-11.3 years in LIFT group and 57.2+/-7.5 years in TVT group. More intraoperative complications arose in the TVT group (six bladder injuries and three haemorrhages versus two in LIFT group, p<0.05). There was no difference for the postoperative time. The mean follow-up was 16.6+/-5.7 months for the LIFT and 32.2+/-11.3 months for the TVT. 80% of the patients were dry in the LIFT and 75.8% in the TVT group. There was no significant difference concerning the rate of de novo urge incontinence (18.3 versus 17.7%) and voiding difficulties (10 versus 16%). On the other hand, 6.7% of the patients of the group LIFT presented bad healing with prosthesis exposure, in every case a partial resection of the mesh was performed. We did not observe any case of exposure in the TVT group.


CONCLUSIONS
The LIFT seems as effective as the TVT with a rate of de novo urge incontinence and voiding difficulties similar to the TVT and to the literature's data. However the rate of 6.7% of exposure leads us to prefer polypropylene meshes.
Boukerrou
M
M
Service de chirurgie gynécologique, centre Oscar-Lambret, 3 rue Frédéric-Combemale, Lille cedex, France. mbouk@free.fr
Just
S Bresson
SB
Girard
J-M
JM
Nayama
M
M
Cosson
M
M
D000368:Aged; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007431:Intraoperative Complications / Q000453:epidemiology; D008875:Middle Aged; D011091:Polyesters; D011126:Polypropylenes; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012828:Silicones; D013526:Surgical Mesh; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D014596:Uterine Prolapse / Q000601:surgery; D014621:Vagina / Q000601:surgery
D011091:Polyesters; D011126:Polypropylenes; D012828:Silicones