[TVT associated with other gynecological operations in the same procedure: results and complications]

We report our experienced with TVT combined with other gynecological procedures, and the complications appeared intraoperative and during the immediate postoperative period.

Between October 2001 and March 2004 76 patients underwent TVT procedures following the classic technique in the Urogynecology and Vaginal Surgery Unit of Las Condes Clinic. Median age was 53 years old. Urodynamic tests had demonstrated genuine stress urinary incontinence (SUI) (49 cases), intrinsic sphincter deficiency (ISD) (5 cases), and mixed urinary incontinence (MUI) (22 cases). In 61 cases (80.3%) TVT was associated with another gynecological surgery.

82 gynecological operations were associated to TVT Twenty one patients underwent 2 procedures (34%) and 40 patients one (66%). Laparoscopic surgery 25 cases (41%). Vaginoplasty was the most frequent procedure in 49 cases (80%), laparoscopic hysterectomy 17 (28%), vaginal hysterectomy 5 (8%), laparoscopically assisted vaginal hysterectomy 5 (8%), laparoscopic tubal ligation 3 (5%), Gargiulo operation 1 (2%), annexectomy 1 (2%), and trachelectomy 1 (2%). Introoperative complications appeared in 4 patients (6.6%). 3 cases of bladder perforation (5%), and 1 case of parietal peritoneum perforation (1.6%). No surgical intervention was necessary to solve complications. Two cases of transitory acute urinary retention appeared in the immediate postoperative period.

Our clinical experience demonstrates that the combination of TVT with other gynecological operations in the same procedure is effective and safe. It enables a more comprehensive solution of patient's problems in the same procedure without increasing morbidity.