The Clinical Study Of TVVT-O On Women’s Stress Urinary Incontinence

Objective:To study the treatment effect of tension-free vaginal tape-obturator (TVT-O) on women’s stress urinary incontinence (SUI) and to investigate the feasibility of combining TVT-O with other gynecological surgeries together to treat SUI and other gynecological diseases simultaneously. The study will further improve the application of TVT-O.Methods:This was a population-based cross-sectional study. Forty-eight women with stress urinary incontinence in the Qilu Hospital of Shandong University from September2005to November2009were included in this study. These patients were divided into two groups:one was TVT-O group which had40patients and the other was TVT-O with other gynecological surgeries group which had8patients. We used clinical cases, questionnaires and telephone-calls to collect data and did a retrospective analysis.Results:1. The average age for TVT-O group was53.08±11.12years. The average age for TVT-O with other gynecological surgeries group was52.63±8.31years. There was no statistical difference between these two groups.2. The average operation time for TVT-O group was22.35±11.20minutes. The average operation time for TVT-O with other gynecological surgeries group was72.88±33.77minutes. There was statistical difference between these two groups with p value less than0.001.3. The average amount of bleeding during operation for TVT-O group was16.75+7.39ml. The average amount of bleeding during operation for TVT-O with other gynecological surgeries group was45.63±22.90ml. There was statistical difference between these two groups with p value less than0.001.4. The average days with urinary catheter for TVT-O group were1.88±1.54days. The average days with urinary catheter for TVT-O with other gynecological surgeries group were2.88+1.81days. There was statistical difference between these two groups with p value less than0.05.5. The average hospitalization days for TVT-O group were4.38±2.06days. The average hospitalization days for TVT-O with other gynecological surgeries group were6.38±1.06days. There was statistical difference between these two groups with p value less than0.05.6. Epidural anesthesia was used in the TVT-O group. General anesthesia was used in the TVT-O with other gynecological surgeries group.7. There was no statistical difference on postoperative complications between these two groups.8. We followed all these48patients for24-48months. The follow-up rate was100%. There was no recurrence of stress urinary incontinence. Forty-seven (98.92%) patients felt the urinary incontinence was completely controlled and cured. They told us that there was no urine leakage with activities which increased abdominal pressure such as coughing, sneezing, jumping and running. Only one patient (2.08%) had a small amount of involuntary urine leakage during jumping and running, however, the symptoms of urinary incontinence were improved greatly.Conclusions:1. TVT-O was a safe and effective surgery to treat women’s stress urinary incontinence.2. It was feasible to perform TVT-O with other gynecological surgeries simultaneously to treat SUI and other gynecological diseases. There were no adverse effects between TVT-O and other gynecological surgeries.3. The short-term and long-term effects of TVT-O were satisfactory. There were no serious irreversible postoperative complications.