ABSTRACT

AIM:

To evaluate the technical aspects and training process of the TVT-SECUR – a novel minimally invasive anti-incontinence operative procedure.

METHODS:

With this prospective, observational and consecutive patient series, the TVT-SECUR operation was taught by one trainer to experienced pelvic floor surgeons on 100 patients with urodynamically proven stress urinary incontinence. Peri-operative data was prospectively collected.

RESULTS:

The surgical aspects of these 100 patient’s parameters were evaluated. No voiding difficulties, significant pain, or any other patient inconvenience was observed post-operatively. The early therapeutic failure rate for the TVT-SECUR procedure was 9.0%. Four patients had vaginal wall penetration with the inserters, requiring withdrawal and re-insertion as well as vaginal wall repair. Three other patients needed trimming of a vaginaly extruded tape segment, done in the office with satisfactory results. Five patients had un-intended tape removal at the time of inserter removal, necessitating the usage of a second TVT-SECUR. No signs for bowel, bladder, or urethral injuries, intra-operative bleeding or post-operative infections were evident.

CONCLUSIONS:

Use of the TVT-SECUR, a novel mid-urethral sling, seems to be a safe anti-incontinence procedure. Operative complications associated with the TVT, such as bladder penetration and post-operative outlet obstruction as well as the TVT-Obturator complications such as post operative thigh pain and bladder outlet obstruction seem to be reduced with the TVT-SECUR.