[Efficacy of suburethral TVT in cases of stress XXXX associated with severe sphincter insufficiency. Report of 22 cases].

@entity1 @entity1690 @entity322 @entity2507 @entity86 @entity74
INTRODUCTION: The TVT system has revolutionized the management of female stress @entity322 (SUI). Less favourable results have been observed in @entity1 with @entity322 associated with a low maximum urethral closing pressure (MUCP). The objective of this prospective study was to evaluate the efficacy of TVT in this situation. MATERIAL AND METHODS: From October 1999 to June 2001, 22 @entity1 between the ages of 53 and 84 years (median: 66.7 years) were operated for SUI with an MUCP < 25 cm @entity2507 (mean: 17.6 cm @entity2507 , range: 6 to 22 cm @entity2507 ) present for more than 8 months (range: 8 to 48 months). Three @entity1 also had associated urgency. The Ulmstem manoeuvre was positive in every case and the Bonney manoeuvre was positive in 19 @entity1 . Insertion of TVT was associated with sacral colpopexy in two @entity1 . Success of treatment was defined by complete absence of @entity322 and @entity74 after the operation. RESULTS: One @entity1 was lost to follow-up. The median follow-up was 7.5 months (range: 3 to 27 months). The mean duration of bladder catheterization was 1.3 days (range: 1 to 5 days). Fifteen @entity1 were completely cured by TVT (71.4%). In these cases, uroflowmetry and post-voiding volume were not affected by the operation. Treatment was ineffective in 6 @entity1 (4 cases of uncontrolled leaks, one case of de novo urge @entity322 , one case of @entity86 with a post-voiding residue of 120 ml). CONCLUSION: The TVT system appears to be an effective method for the treatment of most @entity1 with SUI associated with severe manometric @entity1690 . However, these favourable results need to be confirmed by a longer follow-up.
