TVT AND TOT IN MINIMAL INVASIVE TREATMENT OF THE URINARY STRESS INCONTINENCE IN WOMEN
Abstract:
Prospective evaluation of indication, techniques and results by using minimal invasive antiincontinence
treatment: retropubic tension free vaginal tape (TVT) and transobturatory tape (TOT) in
female patients with urinary stress incontinence (SUI). 156 female patients (p) suffering from SUI were
referred for corrective surgery in the Urology Department Sibiu between2005-2010. Diagnosis
algorithm consisted of: clinical examination, echography, urine examination and uroculture, serological
examination, bladder diaries completed by the patients for 7 days and questionnaires UDI-6 (Urogenital
Distress Inventory) and IIQ-7 (Impact Incontinence Quality of Life). There were excluded patients
suffering from SUI associated with medium and severe urgency and those with urogenital prolapse 2nd
and 3nd according POP (Pelvic Organ Prolapse) classification. Surgical treatment consisted of TVT for
34 p and TOT for 122 p. The overall operative time was 23,1 minutes, on average 30,8±9,3
(media±standard deviation) minutes for TVT and 15,4±4,7 minutes for TOT. Immediate and long term
continence based on clinical examination and bladder diaries was good. The SUI cure rate was 98,07%
(153p/156p). Postoperative satisfaction rate illustrated by TSS questionnaire was 86,35% (137p/ 156p).
Both TVT and TOT are efficient and safe techniques for surgical treatment of SUI in the case of selected
patients, having a positive influence on the quality of life. Short hospital stay, minimal surgical trauma,
fast postoperative recovery and social-professional integration justify the use of minimal invasive
techniques. The advantages of TOT are: the lower risk of bladder lesion and short operative time.
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