TVT--A MODIFIED TECHNIQUE TO IMPROVE VOIDING DYSFUNCTION

Charles R. Hanes II, MD, FACOG

Objective:
The objective of this study is to determine if looser placement of the TVT will provide an alternate technique that does not compromise efficacy and has a lower incidence of voiding dysfunction.

Study Design:
Patients with genuine stress urinary incontinence and hypermobility were randomized into two groups. One group had the TVT adjusted using the cough test; the other using a 12 Hegar dilator. Patients will be evaluated preoperatively and at six weeks. Voiding function will be assessed using residual urine volume, uroflowmetry and UDI-6 and IIQ-7 quality of life questionnaires. 24-hour pad tests, stress tests and questionnaires will be used to assess the presence of incontinence. In addition, patient satisfaction will be assessed.

Results:
The two groups will be compared to determine if there is a difference in voiding dysfunction, patient satisfaction and cure of incontinence.

Conclusions:
If the loosely applied sling is equally efficacious with fewer voiding complaints, it may be a preferred technique.

Key Words:
Voiding dysfunction, TVT