Clinical Analysis Of Tension-free Vaginal Tape ABBREVO(TVT-A) Technique Procedure In The Treatment Of Female Stress Urinary Incontinence

Objective: Minimally invasive suburethral sling procedures havebecome a mainstay for the surgical treatment of female stress urinaryincontinence(FSUI). The hammock hypothesis is introduced by DeLanceyin1994. According to the hypothesis, Ulmsten introduces the tension freevaginal tape(TVT) procedure, which brings the surgical treatment of FSUIin to a golden time. With time going by, complications, such as bladderrupture, mesh exposure, urethra injury, bowel injury, vessel injury,infection, nerve injury and so on, has been reported. In2001, so as to avoidinjury of pelvic organs, an outside-in transobturator approach(TOT) for theplacement of a suburethral tape has been proposed. Compared withretropubic technique, TOT may be associated with lower complicationrates. Yet, clinical studies have shown that injury of pelvic organs canoccur with TOT. The inside-out transobturator vaginal tape(TVT-O) hasbeen developed for the FSUI by De Leval in2003. The TVT-O doesn’tenter the pelvis, it can achieve the aim of minimizing the risk of lowerinjury of pelvic, ensuring mining tissue dissection, and so on. Yet,according to the report that some patients who undergo the TVT-O willsuffer pain in the groin area. Consequently, a new surgical procedure forFSUI, which is called Modified Tension-Free Vaginal TapeABBREVO(TVT-A) is reported. TVT-A has been accepted by more andmore patients. The effectiveness and safety of TVT-A for female stress urinary incontinence was assessed．Methods:43patients who received TVT-A in the First Hospital of JilinUniversity from March,2013to August,2014were included.24hours-Postoperative, bladder rupture, bowel injure, never injure, Operationtime, blood loss, indwelling catheter time, postoperative complications andeffects were evaluated. The postoperative1month urination controlsituation, the groin pain, objective and subjective cure rate, quality of lifescores were evaluated. The patients were followed up before and afteroperation by1h pad test and incontinence quality of lifequestionnaire(I-QOL)．Results: All of the43patients were treated successfully. The meantime of operation was(15.9±3.2)minutes, mean operation bleedingwas(13.8±1.9)ml, indwelling catheter time was(1.8±1.1）d, post-operativehospital stay was(5.7±2.0)d. The rate of postoperative urinary retentionwas5(11.6%). The1h pad test after operation showed the leakagesignificantly decreased than those preoperatively(P<0.01). The score ofI-QOL was better postoperatively than preoperatively(P<0.01)．Conclusions: TVT-A is a surgery that is easy to operate. Comparedwith TVT-O, TVT-A less likely causes groin pain, bladder fistula and so on.It has few complications, satisfied short term cure rate and quality of life．...