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Aim: To assess the outcome of TVT-O procedure performed under local anaesthesia and sedation, with a cough test, on patients with urodynamic stress urinary incontinence with or without intrinsic sphincter deficiency. Methods: A retrospective study analysing the outcomes of 111 women between December 2004 and April 2013. The primary outcome was the resolution of stress urinary incontinence. The secondary outcomes were resolution of urge symptoms, detrusor over activity and occurrence of post-operative complications. Results: The success rate was 99.1% in 106 out of 111, who were followed-up (Range: 6-208 weeks, Average: 23 weeks), including the 30 women (27%) with intrinsic sphincter deficiency. The resolution of urge symptoms and detrusor overactivity occurred in 93% and 85% of women respectively. Urinary retention occurred in 2 women (1.8%). Upper thigh pain occurred in 1.8%, and resolved by 6 weeks. Three women (2.7%) complained of dyspareunia at 6 weeks post-operatively and two of them required tape division. One of these two cases was the only case of mesh exposure in the study (0.9%). There were no other significant complications. Conclusions: Our study demonstrated a subjective cure rate of stress urinary incontinence in 99.1% in patients undergoing the TVT-O procedure under sedation and local anaesthesia, performed with cough test in theatre. It shows low rates of urinary retention and high cure rates for symptoms of detrusor overactivity. These results compare favourably to other published studies.

obstetrics and gynaecology cases - reviews

The Outcome of TVT-O Procedure with Cough Test in Theatre under Local Anaesthesia and Sedation in Women with or without Intrinsic Sphincter Deficiency: Retrospective Case Series of 111 Women