Efficiency of Treatment for Female SUI (Stress Urinary Incontinence) Using the TVT-O® (Tension-Free Vaginal Tape...

The modern Tension-Free Vaginal Tape Obturator (TVT-O®) technique is used worldwide to treat Stress Urinary Incontinence (SUI). The subject of the paper is timely and with a major practical potential. The paper presents an ample retrospective study on a series of patients hospitalized at the Second Clinic of Obstetrics-Gynecology of "Cuza-Vodă" Obstetrics and Gynecology Clinical Hospital from Iasi, for a period of 3 years. In the period January 2010-January 2012, 164 female patients were subjected to surgical procedures to treat type II SUI, inserting TVT-O® tapes.

Patients were selected based on anamnesis, clinical examination and positive Bonney's test. When genital prolapse was associated with SUI, simultaneous with strip insertion, other interventions were practiced, too. Cases were followed in the immediate postoperative period, at 2 months, 6 months, and 1 year, in order to analyze the efficiency of the method. 164 female patients aged between 38 and 65 were included in the study, of which 60 cases had isolated SUI and in 104 of the cases SUI was associated with genital prolapse.

In 85% of the cases, the healing rate was satisfactory, and in 15% of the cases, it was partially satisfactory, keeping the percentage at 6 months and 1 year. In respect of complications at 16 female patients, SUI was improved, but persistent in 14 cases the mictional necessity was described as absent before intervention; in these cases, we used oxybutynin, in 4 of them-tape sectioning and in 4 cases the exteriorization of the tape was relieved after 2 months, performing the secondary vaginal suture. The simple operatory technique, the reduced hospitalization period, the short convalescence and the immediate results support the TVT-O® procedure in the treatment of SUI. Postoperative complications are rare and do not compromise results. The main goal of "Sling" interventions is the creation of a reliable closure mechanism, supporting the passive urinary retention by urethral compression.

Our point of view with regard to the controversy of using TVT-O® tapes is that the technique does not have to be abandoned, being extremely efficient in academic centers with ultra-specialized staff.