Original Article

TFS (Tissue Fixation System) minisling reinforcement of uterosacral ligaments cures nocturia, urgency, frequency, even with minimal prolapse. A 6 months review

  • STEFANO DATI

Pelviperineology 2011;30(2):37-39

Background:

Nocturia is said to have no known cause or treatment. The aim of the study is to help 12 patients with severe nocturia, urgency and frequency given no other hope of cure by minimally invasive surgical reinforcement of damaged uterosacral ligaments. Exclusion criteria: patients with other pelvic symptoms such as stress incontinence.

Materials and methods:

Twelve patients with frequency, urgency, nocturia of serious entity, with POP-Q stage 1, without prior hysterectomy or stress urinary incontinence, were selected for the study. Median age was 63.2 years (37-81), BMI 27.8 (19-44), parity 2.1. Posterior TFS minisling operation with transvaginal access was performed to reinforce the uterosacral ligaments.

Results:

Mean operating time was 15′, with no intra/perioperative complications, and mean hospitalization time 2 days. Review at 3 and 6 months with the ICIQ-N QoL questionnaire showed average score reductions from 7.8 to 2.7 for frequency and 7.2 to 1.9 for nocturia. The score for the OAB questionnaire reduced from 17.6 to 9.8. The cure-rate of symptoms was 62.5% for frequency, 75% for nocturia, and 66.7% for urgency, with no age-related differences.

Conclusions:

The use of the TFS has allowed us to verify, albeit on short follow-up, that this mininvasive procedure can also be applied solely towards the resolution and/or improvement of symptoms which limit the QoL in patients with severe symptoms of nocturia, frequency and urgency without major POP. It is therefore applicable to elderly patients, even with tissues of poor quality.

Keywords: Nocturia; Urgency; Frequency; TFS; Posterior Sling; Integral Theory.