Instruments and TechniquesPerioperative Complications and Early Follow-up with 100 TVT-SECUR Procedures
Section snippets
Methods
In all, 100 consecutive patients with urinary stress incontinence with no intrinsic sphincteric deficiency, based on subjective symptoms and objective clinical signs, confirmed with urodynamic diagnosis including cystometry, uroflowmetry, and stress test, were prospectively and consecutively referred for hammock shape TVT-SECUR. All patients received a thorough consultation and explanation emphasizing the novelty of the procedure and the lack of experience, before giving informed consent. All
Results
A total of 100 hammock-shaped TVT-SECUR operations were performed from September 9, 2006, through December 25, 2006, for the treatment of urodynamic urinary stress incontinence. Patients' preoperative, operative, and postoperative details were tabulated in Table 1, Table 2, Table 3, respectively. According to the pelvic organ prolapse quantification [14], 56 (56.0%) patients had an advanced cystocele (Aa/Ba > +1), 22 (22.0%) had an advanced rectocele (Ap/Bp > +1), 4 (4.0%) had uterine prolapse
Discussion
The TVT procedure has become very popular ever since it was first described in 1996. Common complications with previously performed surgeries for the treatment of stress urinary incontinence, such as intraoperative blood loss, pelvic and abdominal organ injury, postoperative de novo detrusor instability, dyspareunia, and urethral erosion, are rare in the TVT era 1, 2, 3, 4, 5. Prospective randomized multicenter studies, comparing TVT to the former gold standard Burch colposuspension, revealed
Conclusion
These data support the notion that the TVT-SECUR, a new midurethral sling operation for the treatment of female stress urinary incontinence, was associated with mild early safety and efficacy problems. These problems were identified and rectified, making the TVT-SECUR a safe, effective and easy-to-perform operation. Intraoperative diagnostic cystoscopy and bladder catheterization might not be mandatory for an experienced surgeon when using the hammock approach. The TVT-SECUR procedure might be
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The short life cycle of a surgical device - Literature analysis using McKinlay's 7-stage model
2015, Health Policy and TechnologySling surgery for stress urinary incontinence in women: A systematic review and metaanalysis
2014, American Journal of Obstetrics and GynecologyDifferent sling procedures for stress urinary incontinence: A lesson from 453 patients
2014, Kaohsiung Journal of Medical SciencesCitation Excerpt :All the procedures were performed by a single surgeon (H.S.). During this study, the TVT technique used was similar to that described previously by Ulmsten et al. [5], the TVT-O technique was similar to that described by de Leval [7], and the TVT-S technique was similar to that described by Neuman [8]. The surgical technique for PVS was similar to that described in the literature [9].
Short-Term Effect of TVT-SECUR Procedure on Quality of Life and Sexual Function in Women With Stress Urinary Incontinence
2013, Journal of Minimally Invasive GynecologyThe fate of synthetic mid-urethral slings in 2013: A turning point
2013, Arab Journal of UrologyTension-Free Vaginal Tape-O and -Secur for the Treatment of Stress Urinary Incontinence: A Thirty-Six-Month Follow-Up Single-Blind, Double-Arm, Randomized Study
2013, Journal of Minimally Invasive GynecologyCitation Excerpt :After perforation of the obturator membranes with the use of scissors, helical passers were inserted with the use of a guide, and the tape was positioned under the midurethra without tension. TVT-Secur was performed according to the technique proposed by Neuman [18]. After longitudinal incision of the vaginal mucosa for approximately 1 cm, starting 1 cm proximal to the urethral meatus and continued caudally, bilateral paraurethral dissection was carried out up to the pubic bone.
Disclosure: The author was a TVT-SECUR trainer for Ethicon Women's Health and Urology.