Purpose: To compare between TVT-Secur U-type and autologous rectus fascial patch sling in treatment of urodynamic stress urinary incontinence.
Material and Methods: Between September 2008 and November 2011, 120 patients with urodynamic stress urinary incontinence (USI) were selected and randomly divided into two groups. Group 1 included 60 patients who were treated by TVT-Secur U-type, and group 2 included 60 patients who were treated by autologous rectus fascial patch sling. The differences between the two procedures were compared and analyzed. Results: There were no statistically significant difference between TVT- secur and fascial patch groups regarding cure rate (76.7% vs.83.4 %, respectively). In TVT-secur group 10 % were improved versus 13.3 % in fascial patch group. In VT- secur group 8 cases failed, 4 of them had preoperative Valsalva Leak Point Pressure (VLPP) more than 60 cm H2O (intrinsic sphincter deficiency; ISD).On the other hand, in fascial patch group, only 2 cases failed. There was statistically significant differences between TVT-secur group and fascial patch group regarding the mean operative time (group (21.4± 2.2 min vs. 52.3 ± 7.1 min, respectively),and mean blood loss(69 ± 9.6 ml vs. 117.5 ± 24.3 ml, respectively).There were no statistically significant differences between both groups regarding postoperative complications. There were no statistically significant differences between both groups regarding pre and postoperative Qmax or residual urine volume.
Conclusion: This short term follow up revealed no statistically significant differences between TVT-Secur and rectus facial patch sling procedures in the treatment of female SUI. It is recommended that further studies on a larger scale of patients with a longer follow up period following TVT-Secur to assess the efficacy and long term complications specially cases with in patients with intrinsic sphincter deficiency. |
