Suspension of the Lower Third of the Urethra in Out -patient Practice - Minimally Invasive Treatment ofStress Incontinence of Urine - Technique and InitialExperience

Overview

Objective:
The aim of the article is the presentation of a new, miniinvasive method for the treat-ment of urethral incompetence in women - TVT (tension-free vaginal tape).Design and setting: The design was a prospective comparison of the first 10 patients at the Depar-tment of Obstetrics and Gynaecology of the 1 st Medical Faculty and General Faculty Hospital inPrague where urethral incompetence = genuine stress incontinence regardless of their historywas diagnosed consecutively.Methods: We present the technique of the operation, examination procedure including the appli-cation of dynamic magnetic resonance before and after operation at rest and under Valsalva, thesubjective and objective outcome in the analyzed group. We compare also the parameters ofurethrovesical junction mobility in the MR image and discuss their importance for the newcontinence mechanism in the TVT method.Results: All patients are 10 - 18 months after the operation continent. The functional morphologyof the lower urinary tract and of the pelvic floor on the MR image after TVT did not reveal anyrelevant changes in bladder neck dynamic mobility.Conclusion: The experience of other authors concerning possible complications, postoperativecare and results are evaluated; they are without exception positive.

Key words:
genuine stress urinary incontinence, surgery, miniinvasive method