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Concomitant surgery with tension-free vaginal tape
Kuan-Hui Huang1, Fu-Tsai Kung, Hsi-Mi Liang
1Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan. gynh2436@adm.cgmh.com.tw
Acta Obstetricia Et Gynecologica Scandinavica
|September 6, 2003
Summary
Tension-free vaginal tape (TVT) surgery combined with gynecologic procedures is safe and effective for treating genuine stress incontinence (GSI) under general anesthesia. This approach offers high subjective and objective success rates with minimal complications.
Area of Science:
- Urogynecology
- Minimally Invasive Surgery
- Anesthesiology
Background:
- Genuine stress incontinence (GSI) significantly impacts women's quality of life.
- Combined surgical procedures aim to improve efficiency and patient outcomes.
Purpose of the Study:
- To evaluate the efficacy and feasibility of tension-free vaginal tape (TVT) surgery.
- To assess TVT surgery when combined with other gynecologic surgeries under general anesthesia.
Main Methods:
- 106 women with GSI underwent TVT surgery combined with hysterectomy (LAVH or VTH with APC) under general anesthesia.
- Subjective (VAS, questionnaire) and objective (pad test, urodynamics) assessments were performed pre- and post-surgery.
- Follow-up averaged 18 months.
Main Results:
- High subjective (88.6-90.5%) and objective (84.9-86.8%) success rates were observed for TVT surgery combined with hysterectomy.
- Mean hospitalization was 3.5 days (LAVH+TVT) and 4.8 days (VTH+APC+TVT).
- Complication rates were low, including 2% bladder perforation and 11% postoperative voiding difficulty.
Conclusions:
- TVT surgery performed under general anesthesia is safe and effective for GSI treatment.
- Concomitant TVT surgery with gynecologic procedures is feasible and yields favorable outcomes.
- The intraoperative cough provocation test is not necessary for TVT procedures in this context.