| Affiliation: | (1) Section of Gynecologic Surgery, Mayo Clinic, 200 First Street SW, Rochester, Minnesota MN 55905, USA;(2) Division of Biostatistics, Mayo Clinic, 200 First Street SW, Rochester, Minnesota MN 55905, USA;(3) Ohio University College of Osteopathic Medicine at Grandview/Southview Medical Centers, Dayton, Ohio, USA;(4) Department of Urology, Medical College of Ohio, Toledo, Ohio, USA |
| Abstract: | Tactile needle tip control was used to aid perforation during standard tension-free vaginal tape (TVT) placement to treat urinary incontinence. The success and complications of this novel method were compared retrospectively with the reported results of the standard technique. One hundred nine patients had TVT placement between 1998 and 2001, with follow-up continuing into 2002. Preoperatively, the severity of urinary incontinence was assessed objectively. Postoperatively, TVT effectiveness was assessed subjectively by standardized questionnaire, completed by 78 of the 109 patients (72%). Objective 2-year rates for continence or improvement and most complication rates were similar to previously reported results. Needle tip control was helpful in lowering the occurrence of bladder perforation. Longer postoperative recovery times associated with postoperative dysuria or obstruction did not decrease patient satisfaction if the patient experienced a marked improvement in leakage.Abbreviations ISD Intrinsic sphincter deficiency - TVT Tension-free vaginal tape Editorial Comment: The authors report a single-center single-surgeon experience with the TVT sling procedure. It is a series of 109 women in a  real-world setting. As such, inclusion and exclusion criteria as well as endpoints are not well defined and not objective. The study demonstrated good results with the procedure, which are very consistent with many previously published papers. The authors stress important technical aspects of the procedure to avoid migration of the tip of the needle. |
