ABSTRACT

This retrospective case series analyses the outcomes of the first 25 women with stress urinary incontinence (SUI) who were treated by the procedure of TVT-O under local anaesthesia and sedation with the cough test performed in theatre. The study addresses the intraoperative, immediate and medium term postoperative complications and cure rate in absence and presence of intrinsic sphincter deficiency (ISD). In this study all 25 procedures were performed successfully under local anaesthesia and sedation. There were no intraoperative complications or postoperative urinary retention. The short term complication was groin pain in two women (8%) which completely resolved by 6 weeks post surgery. Of the women who had their surgery in the morning 86% were discharged on the same day (within 10 hours). Regarding the only woman on the morning list that was discharged the following day, the delay in her discharge was planned preoperatively due to her medical history. There was only one woman (4%) with intermediate long term complications who developed pain in the vagina that required excision of a small part of the tape. This did not affect her cure from SUI. Two women (8%) developed mild urinary urgency that did not require any further management. 10 women (40%) in the study had ISD with or without hypermobile bladder neck and five out of them had maximum urethral closure pressure less than 20 cm H2O. Only one woman was lost to follow up, all the remaining 24 women (with and without ISD) were cured from SUI in their last follow up (average 13.4 weeks).