PTU - Polskie Towarzystwo Urologiczne
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New method in the treatment of stress urinary incontinence in women with TVT-Secur “U”
Article published in Urologia Polska 2008/61/Supl. 1.

authors

Mariusz Blewniewski, Michał Markowski, Marek Jeromin, Waldemar Różański
II Klinika Urologii UM, WSS im. M. Kopernika w Łodzi

summary

Introduction.

Urinary incontinence (UI) can be regarded as a social disease, because its incidence rate in the general population, in our country, exceeds 5%. The incidence of stress urinary incontinence (SUI) in women is dependent on age, type of work, coincident diseases, as well as obstetric and gynecological history. Elderly age plays an important role in the pathophysiology of SUI, because it is associated with hormonal deficiency, changes in connective tissue structure and long-term physical exertion.

Objectives.

The objective of this study is to present the new TVT S System (tension-free vaginal tape secure system) a new, minimally invasive sling procedure for the treatment of stress urinary incontinence in women.

Materials and methods.

Film presents new minimally invasive technique in the treatment of stress urinary incontinence in women which has been done in our Clinic since 2007. TVT-Secur* System Device - the mesh consists of a 1.1 x 8 cm PROLENE laser cut mesh tape, which is coated on both ends (2 cm on each end) with an absorbable fleece material. The sandwiched fleece is a composite of Vicryl and PDS which provides strong fixation without the use of sutures. This material is usually absorbable within 90 days, with PROLENE* remaining intact to provide long term fixation. A curved stainless steel inserter instrument and “release wire” is attached on both ends to the mesh. The prosthetic implant is placed under the midurethra, and is fixed in the “hammock” position into the obturator internus muscle or in the “U” tape position it is attached behind the pubic bone to the connective tissue of urogenital diaphragm

Results.

High effectiveness of the method was observed post-operatively. The procedure was well-tolerated by all patients, with no significant intra- or post-operative complications observed. Urinary bladder was not injured while the device guiding the tape was being inserted behind the pubic bone. Urine retention after micturition was observed in two women, which regressed completely after 5 days and the symptoms of urgency were reduced within 4 weeks after the procedure, were noted in 1 case.

Conclusions.

TVT Secur “U” method in the treatment of SUI is a new, minimally-invasive, relatively safe and effective procedure in the treatment of SUI, even in cases of recurrences.