Abstract:

The aim of this study is to introduce a new, safe, tension-free vaginal tape (TVT) trocar. Twenty-eight women with stress urinary incontinence who underwent a TVT procedure with a new trocar during a 6-month period were prospectively enrolled in this study. All the operations were performed by the same surgeon who developed the trocar. The trocar has two buttons, which make the tip of the device sharp or blunt. Median age of the study population was 52 years (range, 30–76 years), median number of vaginal deliveries was 3 (range, 1–10). And 57.1% of women were at menopause. Median body mass index was 30.0 kg/m² (range, 23.8–35.2 kg/m²). Preoperative median Valsalva leak point pressure was 78 cmH2O (range, 50–94 cmH2O), while the median maximum urethral closure pressure was 50 cmH2O (range, 14–74 cmH2O). Concomitant prolapse surgery was present in 23 women (82.1%). At the 6-month postoperative visit, objective and subjective cure rates were 89.3% for each. No serious intraopeartive or postoperative complication such as bladder, intestine, or major vessel injury occured. Only 3 women (10.7%) needed blood transfusion, and 2 women (7.1%) had postoperative voiding difficulty. Due to the modifiable tip, this new sling trocar seems safer than the conventional trocars. But large studies are necessary to prove this assumption.

Authors:

Orhan Seyfi Aksakal, MD, Associate Professor, Director of Urogynecology, Mahmut Kuntay Kokanali, MD, Gynecologist, Sabri Cavkaytar, MD, Gynecologist, Melike Doganay, MD, Associate Professor, Chief of Gynecology, Department of Gynecology, Ankara Dr Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey

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