New surgical technique for the treatment of urinary incontinence in Clinic of Obstetrics and Gynecology of Kaunas University of Medicine

There are various surgical methods for the treatment of female urinary stress incontinence. The aim of this study was to evaluate the effectiveness of tension-free vaginal tape (TVT) operation based on a three-year clinical experience and the possibility of its use in the outpatient settings. Materials and methods. The patients were examined according to a standardized protocol for urinary incontinence and were operated on according to the original “Gynecare TVT” protocol. A total of 57 women were operated on and followed up during the study period (02/25/2000–12/31/2002). The average age was 52 years. Out of them 31 (54.4%) women were after menopause and 56 (97.9%) gave birth. Nine women had operations in their medical histories: five had hysterectomies and the other four were operated on because of urinary incontinence. Besides, five women were operated due to mixed urinary incontinence. Among the operated women, 6 had local anesthesia, 13 had epidural, and 38 had lumbar anesthesia. The average time of the operation was 22.3 minutes. The mean hospital stay was 4.4 days. Five patients were hospitalized for one day. Besides TVT operation, eight patients had anterior colporrhaphy, two patients had posterior colporrhaphy, and two patients had “mesh” application for cystocele treatment. Results. One woman had stress urinary incontinence symptoms after operation (the effectiveness of operation was 98.2%). The main complications were: perforation of the urinary bladder was present in 1 (1.8%) patient and infection of urinary tract – in 4 (7.0%) patients. Conclusion. TVT operation is a minimal invasive, fast, safe and very effective surgical procedure for the treatment of urinary stress incontinence, which has to be implemented in Lithuania as a routine outpatient procedure