Suspension of the Lower Third of the Urethra in Out -
patient Practice - Minimally Invasive Treatment of
Stress Incontinence of Urine - Technique and Initial
Experience
Halaška M. 1 , Otčenášek M. 1 , Havel R. 2 , Martan A. 1 , Voigt R. 3 , Feyreisl J. 4 ,
Mašata J. 1
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Summary:
Objective: The aim of the article is the presentation of a new, miniinvasive method for the treat-
ment of urethral incompetence in women - TVT (tension-free vaginal tape).
Design and setting: The design was a prospective comparison of the first 10 patients at the Depar-
tment of Obstetrics and Gynaecology of the 1 st Medical Faculty and General Faculty Hospital in
Prague where urethral incompetence = genuine stress incontinence regardless of their history
was diagnosed consecutively.
Methods: We present the technique of the operation, examination procedure including the appli-
cation of dynamic magnetic resonance before and after operation at rest and under Valsalva, the
subjective and objective outcome in the analyzed group. We compare also the parameters of
urethrovesical junction mobility in the MR image and discuss their importance for the new
continence mechanism in the TVT method.
Results: All patients are 10 - 18 months after the operation continent. The functional morphology
of the lower urinary tract and of the pelvic floor on the MR image after TVT did not reveal any
relevant changes in bladder neck dynamic mobility.
Conclusion: The experience of other authors concerning possible complications, postoperative
care and results are evaluated; they are without exception positive.
Key words:
genuine stress urinary incontinence, surgery, miniinvasive method
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