The Treatment of Stress Urinary Incontinence in Female Patients Using Tension-Free Vaginal Tape(TVT) in Urethral Suspension. Experience of 4 Years


Objectives: Demonstrate our early and preliminary experience with the use of small intestinal submucosa [SIS] as a suburethral sling in the treatment of stress urinary incontinence[SUI] in females.

Patients and Methods: A highly selected cohort of 10 women (average age: 55 years old; range: 44 to 63 years old) with genuine SUI based on clinical and urodynamic evidence. Patients with mixed incontinence, prior anti-incontinence or trans-vaginal surgery were excluded. The SIS suburethral sling was conducted following the same principles as the TVT as a one-day procedure. Patients were followed up at one week, 1, 3, and 6 month after the procedure (average follow up period: is 9 months, range; 7 to 12 months). Postoperative urodynamic evaluation was performed at the 3-month postoperative visit.

Results: Short term re-catheterization was required in only one patient after initial catheter removal. All patients were able to void spontaneously without difficulty by the first postoperative week. No adverse local reactions or erosion was noted among any of our patients. At the last follow up visit; nine patients reported complete cure and one patient reported improvement in the leakage episodes.

Conclusions: Our preliminary results strongly support the feasibility of the use of SIS as a suburethral sling for treatment of SUI. However, long-term follow up results are still awaited to confirm the durability of these encouraging initial results.

KEYWORDS: Small intestinal submucosa [SIS], stress urinary incontinence [SUI], suburethral sling