OBJECTIVE: To evaluate complications and functional outcomes at 1 year and more of a modified Tension-free Vaginal Tape (TVT) technique from that of classic TVT.
PATIENTS AND METHODS: Retrospective study comparing the two techniques. For the modified TVT technique, a peri-urethrovesical hydrodissection was performed. An 18-gauge hollow needle, in which a thread was introduced, was used as an ancillary for the placement of the sling. The sling was secured to the thread and then positioned with it. Bladder filling objectified perforations. An absorbable suture around the sling allowed its descent if necessary.
RESULTS: One hundred and eighteen procedures were performed (54 classic TVT and 64 modified TVT). For the standard TVT and the modified TVT, the vesico-urethral perforation rates were respectively 7.4% and 1.5% (P<0.05), those of reoperations for pulling the sling downward 11.1% and 1.5% (P<0.05). A 1 year and more, healing and satisfaction rates were respectively 83.3% and 79.2% for the standard TVT versus 88.2% and 90% for the modified TVT (NS). The dissatisfaction rate was lower for the modified TVT (P<0.05).
CONCLUSION: By modifying the placement of the classic TVT, it is possible to reduce its complications while maintaining its efficacy.
Written by:
Sergent F1, Gay-Crosier G2, Resch B2, Pons JC3, Marpeau L4 Are you the author?
1Service de gynécologie-obstétrique et médecine de la reproduction, CHU de Grenoble, CS 10217, 38043 Grenoble cedex 09, France; Université Joseph-Fourier, BP 53, 38041 Grenoble cedex 09, France. Electronic address: . 2Service de gynécologie-obstétrique et médecine de la reproduction, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen cedex, France. 3Service de gynécologie-obstétrique et médecine de la reproduction, CHU de Grenoble, CS 10217, 38043 Grenoble cedex 09, France; Université Joseph-Fourier, BP 53, 38041 Grenoble cedex 09, France. 4Service de gynécologie-obstétrique et médecine de la reproduction, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen cedex, France; Faculté mixte de médecine et de pharmacie de Rouen, 22, boulevard Gambetta, CS 76183, 76183 Rouen cedex 01, France.
Reference: J Gynecol Obstet Biol Reprod (Paris). 2013 Dec 10. (Epub ahead of print)
doi: 10.1016/j.jgyn.2013.08.014
PubMed Abstract
PMID: 24332758
Article in French]
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