Pain during the TVT procedure performed under local anesthesia.

The aim of this study was to identify patients' reactions to pain during the TVT procedure performed under local anesthesia and to consider whether this is acceptable;to see how many patients under 70 years of age could be discharged from hospital on the day of operation; and to estimate the rate of complications. This was a prospective descriptive study of 110 unselected women operated upon with TVT plasty for urinary stress incontinence under local anesthesia. The patients all received the same oral and written information, care and advice for the perioperative period. A 100 mm non-hatched VAS scale was used, 0 mm equivalent to no pain and 100 mm indicating unbearable pain. New dose analgesia is normally given postoperatively after other surgical procedures in scores over 30 mm on the VAS scale. Eighty-eight percent of patients scored their pain reaction between 0 and 10 mm, 5% at 11-20 mm, 4% between 21 and 30 mm, 2% at 31-40 mm and 1% (1 patient) at 94 mm. Mean value was 5 mm. Seventy-one percent of the total and 85% of those over 70 years old in the stress and mixed incontinent group without prolapse went home on the day of the operation. There were 2% of bladder perforations and 4% postoperative hematomas; 94% of all patients had a residual urine volume <100 ml within 24 hours. During the procedure most patients felt no pain at all and in all cases but one local anesthesia was well tolerated and accepted. The majority of the patients without prolapse could be discharged on the day of the operation. The complication rate was low and did not affect the hospital stay.