[Tension free vaginal tape--a new surgical method for stress incontinence in women]

A new, minimally invasive procedure for female stress incontinence has recently been developed. A prolene tape is placed without tension under mid-urethra, usually using local anaesthesia and mild sedation. Postoperative catheterisation is not employed. Our experience with the first 42 patients is presented. 42 women with urodynamically verified severe urinary stress incontinence were operated in 1996 and 1997. They underwent subjective and objective follow-up in 1998 with mean follow-up time 16 months, range 6-27 months. The procedure was well tolerated. All patients except four (90%) were discharged within 24 hours. There were two bladder perforations which healed spontaneously, and in one case the vaginal wound required resuturing. Subjectively, 85% were cured of their stress incontinence and a further 10% had slight incontinence only and used no protection. Objectively, 81% were cured and 12% were > 90% improved. There were no cases of long term voiding problems, recurrent urinary tract infections, de novo urge incontinence, or sling rejections. With medium term follow-up this procedure appears to have results equivalent to those of colposuspension, and few complications.