THE PERCUTANEOUS VAGINAL TAPE (PVT) IN THE TREATMENT OF STRESS INCONTINENCE: FIRST YEAR EXPERIENCE

Abstract

Abstract

Introduction: In recent years PVT has gained popularity as a cost-effective alterative for tension-free

vaginal tape (TVT) operation. In this study we evaluated the continence status of patients one year after PVT

surgery.

Materials and Methods: Eleven patients suffering from stress incontinence underwent PVT surgery

between May and August 2003. We retrospectively analyzed the clinical characteristics of the patients. The

surgery was performed under spinal anesthesia. A 1.5 cm wide and 30 cm long polypropylene mesh was placed

in mid-urethral region with the help of Stamey needles projected from supra-pubic region in to the vagina.

Cystocele repair was performed in the same session if needed. At the end of one year patients were evaluated

for their complaints and continence status.

Results: Mean patient age was 51.5 (35-81) years. All the patients had a history of child birth and mean

number of vaginal deliveries were 4.3 (2-12). Two patients described urge incontinence which was not

confirmed to be detrusor over-activity on cystometry. Vaginal examination demonstrated positive Q tip test in

all patients and 4 patients were found to have cystocele. Mean cystometric capacity and Valsalva leak point

pressure were 390 (range: 350-415) ml and 55.5 (50-60) cmH20, respectively. There were no preoperative or

postoperative complications and mean operative time was 69 (40-120) minutes. The urinary catheter was

withdrawn after a mean of 2.5 (2-3) days postoperatively. Mean postoperative post voiding residual urine

volume which was measured by ultrasound was 31 (0-100) ml. Patients were called back 1 year after surgery

and re-evaluated. All 11 patients were symptom free and had no stress or urge incontinence.

Conclusion: PVT is a safe and effective procedure in the treatment of stress incontinence. It can be

performed without any special equipment and it has a low complication rate. Further studies of long time

endurance and reliability of this method should be carried out.