�UroToday.com - The TVT procedure has become very popular of all time since it was number one described by Ulmsten in 1996. Common complications in previously performed surgeries for the treatment of stress urinary incontinence, such as intra-operative blood loss, pelvic and abdominal organ injury, post-operative de novo detrusor instability, dyspareunia and urethral erosion, ar rare in the TVT era.
Prospective randomized multi-center studies, comparing TVT to the other gold standard,Burch colposuspension, demonstrated similar sanative impact for both. However, TVT was associated with a higher intra-operative complication rate spell colposuspension was associated with a higher post-operative complication rate and a thirster recovery period of time. The previously reported TVT-related complications included bladder penetration, intra-operative haemorrhage, post-operative infection and vessel and intestine injuries.
Since surgical procedures are more than likely to cure strain urinary self-gratification rather than non-surgical procedures, Delorme number one and and then de Leval adapted the TVT-Obturator function to stave off the aforementioned complications with the bladder, the femoral blood vessels and the bowel. This is achieved by exploiting the Obturator fossa as a route for the Prolene tape, replacing the retropubic space.
The reported data regarding efficacy of the TVT-Obturator in damage of cure as intimately as intra-operative and early post-operative complication rates is encouraging. Therapeutic failure, intra-operative bleeding, postoperative infection and voiding difficulties also appear to come less with the TVT-Obturator than antecedently reported for TVT. However, the TVT-Obturator is not free of operative complications: thigh-pain is reported to interfere with patient gratification, operative infections and postoperative bladder outlet obstruction inactive occur as well as occasional surgical hemorrhage. The TVT-SECUR was designed to minimize the operative subroutine as much as possible in lodge to reduce those unsought complications. This new device is composed of an 8 cm long optical maser cut polypropylene mesh and is introduced to the internal Obturator muscle (Hammock position) by a metallic inserter, spell no exit skin cuts are required. This approach imitates the sub-mid-urethral support provided with the TVT-Obturator, yet imitating the TVT is possible as well, by introducing the TVT-SECUR arms retropubically rather than to the Obturator area. This "U" position approach necessitates urethral catheterization as well as diagnostic cystoscopy for recognition of possible bladder incursion. As the main
