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In Slovenia tension-free slings (tvt sling) to treat stress urinary incontinence caused by urethral hypermobility and intrinsic sphincter deficiency is used from the year 1998.
In the year 2007 we performed 3 different variations of TVT, classical, TVT-o and TVT-s. TVT-s (secure) is a procedure used from the year 2006 and is less invasive - there is a dramatic reduction in the amount of surgery. The sling penetrates only up to a maximum of 4cm on each side of the urethra. There is much less risk of trauma or bleeding.
In our prospective study we compared 95 women who had TVT surgery for incontinence. In the group A (29 patients) tvt-o was performed and in the group B (66 patents) TVT-s. The average age of patients was 55 years. In both groups patients had the same average number of vaginal deliveries (2 or 3) and had no cesarean sections. The mean time of urinary incontinence in both groups was about 6 years; the menopausal status in both groups was the same (pre-40%, post-60%).
The local anesthesia was used in group Ain 52% and in group B in 42%, and the procedure lasted about the same, from 10 minutes, up to 130 minutes, depending on if tvt was performed alone or in combination with other surgical procedures. Intraoperative complications were found in one patient with tvt-s and none in tvt-o.
Postoperative complications were urine retention in one patient with tvt-s and 2 patients in both groups had urinary tract infection. The mean time from surgery until spontaneous micturiton was 6,86 and 11,90 hours in group A and B respectively. Patients from group A were discharged from the hospital averagely 1,5 days after surgery and from group B averagely 2,48 days.
We found no significant differences in results between TVT-o and TVT-s as a treatment for urinary incontinence. We didn’t compare groups after the patients were discharged from our hospital. That is the aim of our future research.