[Suspension of the lower third of the urethra in ambulatory practice--minimally invasive treatment of urinary stress incontinence--technique and initial experience].

The aim of the article is the presentation of a new, mini-invasive method for the treatment of urethral incompetence in women--TVT (tension-free vaginal tape).The design was a prospective comparison of the first 10 patients at the Department of Obstetrics and Gynaecology of the 1st Medical Faculty and General Faculty Hospital in Prague where urethral incompetence = genuine stress incontinence regardless of their history was diagnosed consecutively.We present the technique of the operation, examination procedure including the application of dynamic magnetic resonance before and after operation at rest and under Valsalva, the subjective and objective outcome in the analyzed group. We compare also the parameters of urethrovesical junction mobility in the MR image and discuss their importance for the new continence mechanism in the TVT method.All patients are 10-18 months after the operation continent. The functional morphology of the lower urinary tract and of the pelvic floor on the MR image after TVT did not reveal any relevant changes in bladder neck dynamic mobility.The experience of other authors concerning possible complications, postoperative care and results are evaluated; they are without exception positive.