title: [A comparative study between two procedures of TVT retropubic mid-urethral sling placement for treatment of female stress urinary incontinence].
abstract: OBJECTIVE
  To evaluate complications and functional outcomes at 1 year and more of a modified Tension-free Vaginal Tape (TVT) technique from that of classic TVT.
  
  
  METHODS
  Retrospective study comparing the two techniques. For the modified TVT technique, a peri-urethrovesical hydrodissection was performed. An 18-gauge hollow needle, in which a thread was introduced, was used as an ancillary for the placement of the sling. The sling was secured to the thread and then positioned with it. Bladder filling objectified perforations. An absorbable suture around the sling allowed its descent if necessary.
  
  
  RESULTS
  One hundred and eighteen procedures were performed (54 classic TVT and 64 modified TVT). For the standard TVT and the modified TVT, the vesico-urethral perforation rates were respectively 7.4% and 1.5% (P<0.05), those of reoperations for pulling the sling downward 11.1% and 1.5% (P<0.05). A 1 year and more, healing and satisfaction rates were respectively 83.3% and 79.2% for the standard TVT versus 88.2% and 90% for the modified TVT (NS). The dissatisfaction rate was lower for the modified TVT (P<0.05).
  
  
  CONCLUSIONS
  By modifying the placement of the classic TVT, it is possible to reduce its complications while maintaining its efficacy.
authors: Service de gynécologie-obstétrique et médecine de la reproduction, CHU de Grenoble, CS 10217, 38043 Grenoble cedex 09, France; Université Joseph-Fourier, BP 53, 38041 Grenoble cedex 09, France. Electronic address: fsergent@chu-grenoble.fr.
authors: F
authors: F
authors: Sergent
authors: Service de gynécologie-obstétrique et médecine de la reproduction, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen cedex, France.
authors: G
authors: G
authors: Gay-Crosier
authors: Service de gynécologie-obstétrique et médecine de la reproduction, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen cedex, France.
authors: B
authors: B
authors: Resch
authors: Service de gynécologie-obstétrique et médecine de la reproduction, CHU de Grenoble, CS 10217, 38043 Grenoble cedex 09, France; Université Joseph-Fourier, BP 53, 38041 Grenoble cedex 09, France.
authors: J-C
authors: JC
authors: Pons
authors: Service de gynécologie-obstétrique et médecine de la reproduction, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen cedex, France; Faculté mixte de médecine et de pharmacie de Rouen, 22, boulevard Gambetta, CS 76183, 76183 Rouen cedex 01, France.
authors: L
authors: L
authors: Marpeau
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D053825:Suburethral Slings / Q000009:adverse effects; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000379:methods
keywords: Aiguille modifiée de TVT; Complications; Hydrodissection; Incontinence urinaire d’effort; Modified TVT needle; Stress urinary incontinence