Impact of the Tension Adjustment of the mesh by using Babcock Clamp during Tension-Free Vaginal Tape Obturator Procedure on the Postoperative Voiding Pattern and Satisfaction

ABSTRACT

PURPOSE: To guarantee the proper tension of the tape, we have adopted standardized methods by using Babcock clamp. MATERIALS AND METHODS: Medical records of 118 women who underwent Tension-Free Vaginal Tape Obturator (TVTO) prucedure were retrospectively reviewed. Tension of the tape was controlled either by holding the 1 cm length of the mesh with Babcock clamp in 72 cases (Group I), or by placing Metzenbaum scissor between the tape and the urethra in 46 cases (Group II) before pulling on the tape. The preoperative evaluations included symptom questionnaire, history taking, physical examination, one hour pad test and complete multichannel urodynamic study. Postoperatively, uroflowmetry, postvoiding residual urine volume and symptom questionnaire were repeated. RESULTS: The success rates of the operation were not different between groups. However, postoperative complication rates, including persistent pain and de novo urgency, in the Group II (n=9, 19.6%) was higher than in Group I (n=6, 8.3%). The rate of postoperative transient urinary retention was also higher in Group II (p<0.05). The rate of the patients who answered [satisfied] were significantly high in Group I (95.8%) compared to Group II (80.4%). CONCLUSIONS: By using the Babcock clamp technique, the complications can be minimized, and satisfaction increased. Our findings suggest that this technique does assure the proper tension for the normal voiding postoperatively.