title: Outpatient mid urethral tissue fixation system sling for urodynamic stress urinary incontinence: 1-year results.
abstract: OBJECTIVE
  We tested the feasibility of using the tissue fixation system to create a mid urethral sling for urodynamic stress urinary incontinence at a freestanding outpatient facility. The tissue fixation system is a new mini sling device with a 1-way tightening system.
  
  
  METHODS
  We performed 44 mid urethral tissue fixation system sling operations between December 2006 and March 2008 at Yokohama Motomachi Women's Clinic LUNA. All patients had urodynamic stress urinary incontinence, as proven by preoperative urodynamics.
  
  
  RESULTS
  Mean +/- SD patient age was 58.2 +/- 11.9 years. Surgery was done on an outpatient basis using local anesthesia. Postoperative pain was minimal. All patients were discharged home the same day. Mean operative time, including local anesthesia administration, was 24.5 +/- 7.7 minutes (median 25, range 15 to 50). Mean blood loss was 17.7 +/- 21.7 ml (median 5, range 3 to 98). Five patients who could not pass urine within 8 hours were discharged home with an indwelling Foley catheter but they passed urine normally within 48 hours. The cure rate at 12 months was 90.9% (40 of 44 cases). Of the patients 15 (34.4%) had intrinsic sphincter deficiency. Three of the 4 failed cases were cured by another tissue fixation system mid urethral sling inserted at 6 months. There was no de novo urgency or urge urinary incontinence at 12 months.
  
  
  CONCLUSIONS
  Results show that the tissue fixation system mid urethral sling operation is a simple, safe, effective procedure that may be done without difficulty at a freestanding clinic on an outpatient basis.
authors.affiliation: Yokohama Motomachi Women's Clinic LUNA, Yokohama, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Sekiguchi
authors.forename: Manami
authors.initials: M
authors.lastname: Kinjyo
authors.forename: Hiromi
authors.initials: H
authors.lastname: Inoue
authors.forename: Hisaei
authors.initials: H
authors.lastname: Sakata
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kubota
mesh_terms: D000556:Ambulatory Surgical Procedures; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D011474:Prosthesis Design; D053825:Suburethral Slings; D013997:Time Factors; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000379:methods