The aim of the study was the analysis of perioperative complications in women who were randomly assigned to receive two different techniques for the treatment of stress and mixed urinary incontinence. Our study included 120 women in whom we performed either TVT-O or Monarc procedure in local anesthesia. The duration of the operation and its likely complications were followed up. The success of treatment was evaluated after 3 months. Surgical time was identical for both procedures (13 min). The prevalence of vaginal wall perforation and laceration was higher during the outside-in procedure. The inside-out procedure was more painful (p < 0.000), the pain persisted significantly longer (21.6 vs 7.5 days; p = 0.03) and was more intense after discharge in these patients. In conclusion, inside-out and outside-in procedures are equally successful methods for the treatment of urinary incontinence at 4 months, however, inside-out procedure appears to be more painful.
A 55-year-old woman with stress urinary incontinence underwent a tension-free vaginal tape (TVT) procedure. Two months after the procedure she complained of suprapubic pain occurring at the end of micturition. Not until 8 months after surgery was the pain found to be due to intramural position of the prolene tape. The operative method used to remove the tape, thus eliminating this late complication of an otherwise successful procedure, is also described.
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