Premium
Retropubic tissue fixation system tensioned mini‐sling carried out under local anesthesia cures stress urinary incontinence and intrinsic sphincter deficiency: 1‐year data
Author(s) -
Nakamura Ryoko,
Yao Masahiro,
Maeda Yoshiko,
Fujisaki Akiko,
Sekiguchi Yuki
Publication year - 2017
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.13360
Subject(s) - medicine , urinary incontinence , surgery , sling (weapon) , urethra , local anesthesia , sphincter , anesthesia , leak , environmental engineering , engineering
Objectives To assess the outcomes of the tissue fixation system midurethral sling for the treatment of intrinsic sphincter deficiency. Methods We retrospectively studied a total of 96 intrinsic sphincter deficiency patients treated with the tissue fixation system midurethral sling at Yokohama Motomachi Women's Clinic from 2006 to 2015. We evaluated intraoperative and 1‐year postoperative results. Regarding the cure rate, we divided patients into three groups: (i) patients with maximum urethral closure pressure <20 and Valsalva leak point pressure <65 combined ( n = 17); (ii) patients with maximum urethral closure pressure <20 ( n = 55); and (iii) patients with Valsalva leak point pressure <65 ( n = 47). Results The median age was 63 years (range 38–89 years). The median operating time including local anesthesia was 24 min (range 12–55 min) and median blood loss was 5.0 mL (range 3–69 mL). All operations were day surgery under local anesthesia. Postoperative pain was minimal. All patients were discharged the same day. There were no intraoperative complications except one bladder perforation. There were no tape rejections. The 1‐year postoperative cure rates were: 88.2% among patients with maximum urethral closure pressure <20 and Valsalva leak point pressure <65, 90.9% for patients with maximum urethral closure pressure <20, and 85.1% among patients with Valsalva leak point pressure <65. Conclusions The tissue fixation system midurethral sling operation is a simple, safe and effective operation for older women with intrinsic sphincter deficiency, and it can be carried out under local anesthesia.