C G Nilsson1, N Kuuva. 1. Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, Finland.
Abstract
OBJECTIVES: To evaluate the effectiveness and safety of the ambulatory, minimally invasive tension-free vaginal tape procedure in women scheduled for incontinence surgery. DESIGN: A prospective open study with a standardised protocol for pre- and post-operative evaluation. PARTICIPANTS: One hundred and sixty-one consecutive women with urodynamically proven stress incontinence. The mean age was 56 years; 45 women (28%) had recurrent incontinence, 59 women (37%) had mixed incontinence and 18 women (11%) had a low pressure urethra. MAIN OUTCOME MEASURES: Subjective and objective cure rates, complications and length of hospital stay. RESULTS: The average follow up time was 16 months. Ninety-four percent of the treated women were completely cured or significantly improved. Eighty percent of the women were released from hospital on the afternoon of the day of surgery. There were no major complications and 80.2% of the women had no complication at all. Seven women (4.3%) had no more than four days of urinary retention problems, five women (3.1%) developed de novo urge symptoms, ten women (6.1%) had urinary tract infection, six cases (3.7%) of intraoperative bladder perforation occurred and less than 3% had bleeding or infection problems. There was no difference in the cure rate between women suffering from primary, recurrent or mixed incontinence. CONCLUSIONS: The tension-free vaginal tape operation is an effective and safe procedure for treatment of most cases of female urinary stress incontinence. The operation can be performed as an ambulatory procedure because of the low risk of post-operative morbidity.
OBJECTIVES: To evaluate the effectiveness and safety of the ambulatory, minimally invasive tension-free vaginal tape procedure in women scheduled for incontinence surgery. DESIGN: A prospective open study with a standardised protocol for pre- and post-operative evaluation. PARTICIPANTS: One hundred and sixty-one consecutive women with urodynamically proven stress incontinence. The mean age was 56 years; 45 women (28%) had recurrent incontinence, 59 women (37%) had mixed incontinence and 18 women (11%) had a low pressure urethra. MAIN OUTCOME MEASURES: Subjective and objective cure rates, complications and length of hospital stay. RESULTS: The average follow up time was 16 months. Ninety-four percent of the treated women were completely cured or significantly improved. Eighty percent of the women were released from hospital on the afternoon of the day of surgery. There were no major complications and 80.2% of the women had no complication at all. Seven women (4.3%) had no more than four days of urinary retention problems, five women (3.1%) developed de novo urge symptoms, ten women (6.1%) had urinary tract infection, six cases (3.7%) of intraoperative bladder perforation occurred and less than 3% had bleeding or infection problems. There was no difference in the cure rate between women suffering from primary, recurrent or mixed incontinence. CONCLUSIONS: The tension-free vaginal tape operation is an effective and safe procedure for treatment of most cases of female urinary stress incontinence. The operation can be performed as an ambulatory procedure because of the low risk of post-operative morbidity.
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