Introduction. Stress urinary incontinence is an involuntary leakage of urine
on a sudden increase of intra-abdominal pressure by physical activity,
exercise, coughing, sneezing or laughing. Objective. To assess symptoms,
functional and anatomical status of voiding function, complications and short
term success of a novel procedure, tension-free vaginal tape obturator
technique (TVT-O) in the treatment of stress urinary incontinence. Methods. A
prospective study was performed on 40 female patients who underwent the TVT-O
suburethral sling at the Urology Department of the Health Centre in Prokuplje
and Urology Hospital in Nis between May 2009 and February 2010. The mean
patients? age was 58 years (range 34-84 years). Preoperative evaluation
included a detailed history and gynaecologic examination including urodynamic
testing and voiding studies.UDI-6 and UIQ-7 score testing was performed
before, and six months after surgery. All patients who demonstrated stress
urinary incontinence with a Q-tip test-angle during maximal straining were
included into the study. Postoperatively, outcomes evaluation included
voiding function, anatomical parameters, complications, as well as subjective
success rates. Results. In 30 patients surgery was performed under spinal and
in ten under general anaesthesia. The average intraoperative blood loss
during the TVT-O was minimal (<50 ml). There were no vascular, bladder,
bowel, and neurological injuries. Thirty-eight patients (95%) were discharged
voiding satisfactorily. There was a statistically significant difference in
symptoms between UDI-6 and UIQ-7 before and after surgery. Conclusion.
Initial experience with TVT-O suburethral sling is promising. The TVT-O
differs from retropubic procedures by resulting in lower postoperative
morbidity, intraoperative and postoperative complications.
Transobturator tension-free “inside-to-out” suburethral sling procedure for the treatment of stress urinary incontinence
