Retrospective study on tension-free vaginal tape obturator (TVT-O)

Abstract

The TVT-O is effective in treating female SUI with minimal complications.

Surgical Complications with Synthetic Materials

“…Abouassaly et al (2004) reported persisting suprapubic discomfort in 18 (7.5%) (18/241 patients). Rajendra et al (2011) after following up 419 patients for 3 years reported persistent pain in 15 patients (3.6%). Ross et al (2009) reported 199 patients, 105 of these had a TVT inserted and 94 patients had a TVT-O; they documented in the vaginal examination that the mesh was palpable in 68 (80%) in the TVT-O group and in 24 (27%) of the TVT group ( RR 0.22, CI 95% 0.13-0.37, P<.001); many women are also experiencing groin pain during vaginal palpation, 13 patients (15%) in the TVT-O group and 5 patients (6%) in the TVT group.…”

“…Barry et al (2011) in a multicentric, randomized trial comparing TVT-Monarc at 3 months follow up, report a bladder lesion in 7/140 patients with TVT and 0/140 patients with Monarc. Rajendra et al (2011) reported 419 patients with stress urinary incontinence at 3 years follow up, 2 patients (0.5%) with bladder perforation. Latthe et al (2010) in his systematic review of 4 articles, report that bladder lesions with the TOT procedure have an OR 0.11 (IC 95% 0.05-0.25) and TVTO has an OR of 0.15 (IC 95% 0.06-0.35).…”

“…Kristensen et al (2010) in 778 patients with TVT reported hemorrhage that needed transfusion in 5 patients (0.6%), Barry et al (2011) observed that bleeding is minor in the group of patients with Monarc, 49 ml; in the TVT group it was 64 ml (p < 0.05), likewise surgical time was 14.6 min with Monarc and 18.5 min with TVT (p < 0.001). Rajendra et al (2011) reported that of 419 patients with TVT-O, 3 patients (0.8%) had a blood loss over 200 ml. Dunn et al (2004) reported 30 cases with vascular injury including 2 fatalities.…”

“…Clinical examination revealed hyperthermia to 40 0 C, sling exposure at right vaginal sulcus and severe cellulitis in the genital-crural fold: Classification: 3C T4 S 2 and 6C T4 S3 Lee et al(2011) in four of the five patients presented with symptom of chronic vaginal discharge and these patients have a chronic infection forming a sinus tract into the vagina or other viscus, causing symptoms years after its mesh placement. Rajendra et al (2011) reported after a 3 year follow up, that 11 patients with TVT-O (2.6%) (11/419) were readmitted since 10 patients had voiding dysfunction, in 6 patients it was necessary to remove or cut the tape. Reich et al (2011) reported it in 108 patients in a follow up period of 102 months (range of 85-124).…”

Modified pubovaginal sling technique in the surgical management of female stress urinary incontinence

“…Currently, this operation with synthetic sling is considered the gold standard in the correction of SUI 5,6 . However, it is not without its adversities, such as extrusion, erosion, infection, and vessels, bowel or bladder perforations [7][8][9][10][11] . Taking into account all these factors and the clarification that it is necessary to the patient, an important part in the treatment choice, we decided to evaluate the implementation of an aponeurotic sling through a modified technique with direct visualization of the needles in patients with stress urinary incontinence.…”