Tension-free vaginal tape (TVT): minimally invasive technique for stress urinary incontinence (SUI).

OBJECTIVE The procedure o tension-free vaginal tape (TVT) was recently introduced in the therapeutic armamentarium of stress urinary incontinence (SUI). It is a pubovaginal sling applied in mid-urethra. The authors describe their experience with this technique. MATERIALS AND METHODS During the period of May, 1999 to March, 2001, 110 patients (median age=53 years) were submitted to TVT implant for the treatment of stress urinary incontinence. Clinical exam and urodynamic studies were performed previously to surgery. All patients referred symptoms consistent with stress incontinence, and 35.7% complained of associated voiding urgency. Sixty-eight percent of the group reported previous continence procedure. Urethral hypermobility was diagnosed in 42% of patients (mean Valsalva leak point pressure under median effort of 110 cmH(2)O), and 58% had intrinsic sphincter deficiency (mean Valsalva leak point pressure under effort of 55 cmH(2)O). RESULTS Mean patient follow-up was 18 months. Ninety-two percent of the patients were submitted to anesthetic blockade and 8% to local anesthesia. Mean length of the procedure was 30 minutes. Dystopy correction, when present, was performed in the same procedure. Mean hospital stay was 24 hours. There was bladder perforation in 13% of cases of TVT. There was no urethral or vaginal erosion. Twenty patients (18%) developed urgency symptoms during post-operative period, and 5 (4.5%) presented urge incontinence. During this follow-up period, 81% remained continent, 9% referred improvement of the symptoms compared to before the procedure and 10% were not satisfied. CONCLUSION Our data allow us to conclude that TVT procedure is safe, rapid and promoting adequate levels of continence in mean term.