ABSTRACT
PURPOSE: A sling operation using tension-free vaginal tape (TVT) has been recently developed and popularized. In order to overcome the problem that the location of the TVT procedure is limited to the mid-urethra, the therapeutic effectiveness of the TVT sling through bladder neck approach was investigated and compared with that through the mid-urethra approach. MATERIALS AND METHODS: Out of 127 stress urinary incontinence patients, 78 patients were assigned to Group A (the mid-urethra approach) and 49 patients were assigned to Group B (the bladder neck approach). The data was analyzed according to age, grade, time of operation, postvoiding residual urine volume, postoperative complications, success rate and the patient's satisfaction. RESULTS: Both groups were mainly Grade I in Stamey grade. There was no significant difference in the surgery time between the two groups, with an average of 23 minutes and 24 minutes, respectively. Of the total number of SUI patients, 12% of Group B patients had a postvoiding residual urine volume larger than 100ml while 6% of Group A patients had a similar residual urine volume. In both groups, severe complications and discomfort were very rare. The success rates of the two groups were similar, 95% versus 96% respectively, and similar results were shown in the patients' satisfaction. Overall, there was no significant difference between two groups. CONCLUSIONS: In the TVT sling operation, the mid-urethra approach is the standard for SUI treatment. However, bladder neck approach has an equivalent effect. Therefore, it is believed that this site for the TVT will lead to more surgical approaches.