The aim of this prospective multicenter study was to evaluate the safety and efficacy of tension-free vaginal tape (TVT) for the surgical treatment of female stress incontinence. Four hundred and four women underwent the TVT procedure. Their mean age was 57 years (range 31-83). The median follow-up time was 21 months (range 12-35). The subjective and objective cure rates were 92% and 90%, respectively. Another 4% of the women were significantly improved by the procedure. Intra- and postoperative complications were few and included uneventful bladder perforations (6%), retropubic bleeding requiring surgery (0.5%), voiding difficulties (4%) in the postoperative course, and one obturator nerve injury. We conclude that the TVT procedure is associated with a high cure rate and a low morbidity.

Neuromodulation can be considered an option for fecal incontinence. However, an accurate clinical and instrumental evaluation and careful patient selection are required to optimize outcome.

The objective of this study is to evaluate the efficacy and morbidity of the new minimally invasive TVT-secur procedure. This was a prospective multi-centre trial. All patients with primary urodynamic stress urinary incontinence were prospectively selected to receive the TVT-secur procedure. The International Consultation on Incontinence-Short Form (ICIQ-SF), Women Irritative Prostate Symptoms Score (W-IPSS), Patient Global Impression of Severity (PGI-S) and Patient Global Impression of Improvement (PGI-I) questionnaires were used to evaluate the impact of incontinence and voiding dysfunction on quality of life (QoL) and to measure patient's perception of incontinence severity and improvement. The SPSS software was used for data analysis. From November 2006 to September 2007, 95 consecutive patients were enrolled in the study. At 1 year, 91 patients were available for the analysis. The subjective and objective cure rates were 78% and 81%, respectively. The ICIQ-SF and W-IPSS symptoms score showed a statistically significant decrease. Post-operative complications included voiding difficulty, recurrent UTI, de novo urgency incontinence and dyspareunia. Our data show that TVT-secur is associated with an 80% success rate at 1 year.

In the short-term follow-up, the Ajust™ system was effective in restoring continence in more than 85% of subjects with a highly significant improvement in QoL.

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