Stress urinary incontinence is a condition that directly affects patients life’s quality. The ideal surgical treatment would be the one free, or the minimum morbidity allied to a high rate of success (dry patient).
The TVT is a recent technique. The only follow-up of 5 years that exists is the one of its inventor (Ulmsten), but it leaves us optimistic because the rate of initial and long term cure compare to classical surgeries that are recognized as being effective (Burch4,5 and Sling6) with the advantage of a low morbidity. Besides this, some casuistry2 have shown an improvement of the irritative symptoms resulting from detrusor overactivity. Taking into consideration that the irritative symptoms resulting from the detrusor overactivity have a bigger impact on the life quality of the patients, we consider it as na important finding.
The above described case allows us to say that the TVT can be used with sucess a second time, on the same patient, mainly when the cause of failure was due to the technique and not by indication (in the described case it was because we sutured the tape with absorbable thread).
More studies must be made to prove the reproductiveness of the method and success at long term (5 years or more) in other acts and to be able to define which would be the cases that the TVT can be repeated on the same patient.