Treatment for female stress urinary incontinence with tension-free vaginal tape obturator procedure: clinical analysis of 38 cases

Objective To determine the effectiveness and complications of tension-free vaginal tape obturator procedure(TVT-O)as a new surgical treatment method for female stress urinary incontinence (SUI).Methods TVT-O was undergone for 36 female patients with established SUI(including 16 mild cases,18 moderate cases and two severe cases)and two cases with mixed urinary incontinence(MUI).Operation time and intra-operation bleeding in the patients were analyzed.The patients were followed-up to observe the effectiveness and complications of this new procedure.Results Age of the 38 patients undergone with this procedure averaged 56.4 years,with a mean operation time of 38.3 minutes,ranging from 30 to 50 minutes.Patients were followed up for two to 29 months(averaging 12.7 months),with four cases lost to follow-up.No bladder or urethral injuries,and no vascular(hematoma or bleeding)and neurological complications were encountered in 38 of them after the procedure.Among four cases(10.5percent)complicated with urinary retention,catheter was removed in ten to 14 days after its indwelling in three cases,with residual urine less than 100 ml.Only one patient still had dysuria nine days after catheter indwelling,but her symptoms improved by adjusting the position of sling to the middle of her urethra under local anesthesia.Twenty-seven cases(71.1 percent)were fully cured without any subjective symptoms left,symptoms improved in four cases(10.5 percent),no response in two cases(5.3 percent),and symptoms of SUI disappeared in one case of MUI,but no release in her urgency urinary incontinence.Conclusions TVT-O procedure is a mini-invasive,safe,effective,accurate and quick surgical operation in treatment for female SUI,unnecessary with regular cystoscopy during the procedure.But its long-term effectiveness is still under follow-up and observation. Key words: Urinary incontinence,stress;  Gynecologic surgical procedures; Therapy