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Commented Abstracts

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  • A three-year follow up of tension free vaginal tape for surgical treatment of female stress urinary incontinence.
    Department of Obstetrics and Gynaecology, Uppsala University Hospital, Sweden. Br J Obstet Gynaecol ,v.106, p.345-50, 1999.


Objective: To study the long term results of tension-free vaginal tape, a new ambulatory surgical procedure for treatment of female stress urinary incontinence. STUDY DESIGN: A prospective open study using a standardised protocol for pre- and post-operative evaluation.

Participants: Fifty consecutive women participated in the study. All suffered from genuine stress incontinence. The mean age was 57 years (SD 11), 42 women (84%) were multiparous, 8 (16%) nulliparous.

Surgical Method: Tension-free vaginal tape implies the implantation of a prolene tape around mid-urethra via a minimal vaginal incision. The procedure is carried out under local anaesthesia, allowing the surgeon to check intra-operatively that continence has been obtained.

Results: All the women except one could be operated on an ambulatory basis under local anaesthesia. Mean operation time was 29 minutes (range 1647). Ninety percent of the women were able to micturate spontaneously within 24 hours with insignificant residual volumes. In another 10% of the women an in-dwelling catheter had to be used temporarily. There was no need for long term postoperative catheterisation (> 14 days). Post-operative evaluation was carried out after 2 to 6, 12, 24 and 36 months. According to the protocol, 86% of the women were completely cured and another 11% were significantly improved. No signs of deterioration of the results over time were observed. No defect in healing or rejection of the tape occurred.

Conclusion: We consider the tension-free vaginal tape operation to be a safe and effective surgical procedure for the treatment of female urinary stress incontinence. The technique can be considered as na ambulatory procedure performed under local anaesthesia, allowing the majority of the women to be discharged from the clinic the same day or the day after the procedure.

Aparecido Donizete Agostinho .

1. Ulmsten U, Henriksson L, Johnson P, Varhos G. An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence Int Urogynecol J, 7: 81-6, 1996.
2. Petros P, Ulmsten U. An integral theory and its method for the diagnosis and management of female urinary incontinence. Scand J Urol Nephrol, (Suppl 153): 1-93, 1993.

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