title: The effect of local anaesthetic infiltration on urethral function during the tension-free vaginal tape (TVT) procedure.
abstract: Different anaesthetic techniques are used for the tension-free vaginal tape (TVT) procedure. Using local anaesthetic and spinal techniques allows surgeons to adjust sling tension with the cough test. The aim of this study was to asses whether the periurethral infiltration of the local anaesthetic technique for TVT results in a significant alteration in urethral function. Twenty-five women who underwent a TVT procedure for stress incontinence were studied prospectively. Urethral function was assessed with the urethral retro-resistance pressure (URP) before and after the infiltration of local anaesthetic. Paired t tests were used to compare values. The mean URP value was 48.0 cm/H2O (SD, 18.4) before and 52.0 cm/H2O (SD, 34.5) after the periurethral infiltration of local anaesthetic. There was no statistical significance between the two groups (p = 0.37). Local anaesthetic does not alter urethral function, as measured by URP, allowing coughing to mimic non-anaesthetic conditions.
authors.affiliation: Department of Obstetrics and Gynaecology, Medway Maritime Hospital, Gillingham, Kent ME7 5NY, UK. jraduckett@hotmail.com
authors.forename: Jonathan R A
authors.initials: JR
authors.lastname: Duckett
authors.forename: Nick S
authors.initials: NS
authors.lastname: Papanikolaou
authors.forename: Maria
authors.initials: M
authors.lastname: Eaton
mesh_terms: D000772:Anesthesia, Local / Q000009:adverse effects*; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D053825:Suburethral Slings; D013526:Surgical Mesh; D014521:Urethra / Q000187:drug effects / Q000502:physiology; D014549:Urinary Incontinence / Q000601:surgery*; D014554:Urination / Q000187:drug effects / Q000502:physiology*; D013520:Urologic Surgical Procedures; D014596:Uterine Prolapse / Q000601:surgery