As like most gynecologic operations, after tension-free vaginal tape, urinary catheter usually has been stayed to prevent postoperative urinary retention. Our aim at this study was to compare effects of early versus delayed catheter removal after tension-free vaginal tape. Patients with stress urinary incontinence observed with cough stress test or intrinsic sphincter deficiency detected on urodynamic evaluation were included. Patients with pelvic organ prolapse, positive or unavailable preoperative urine culture report, comorbid systemic illness, and TVT performed with benign or malign gynecologic surgeries were excluded from the study. Computer-generated randomization was used, and allocation group was kept in closed envelope: group I: catheter removed within first 6 h after surgery (0-6 h) and group II: catheter removed 24 h later. Seventy patients performed TVT for stress urinary incontinence were enrolled in this study and equally assigned to two groups. Of 35, 4 patients (11.4%) required recatheterization in group I while no one from late removal group. Twelve patients (34.2%) had positive culture at day 2 postoperative from group II as compared with 4 patients (11.4%) of group I (P = 0.042). Both of the two groups' success rate after postoperative 2 weeks examination with cough-stress test was similar to 32 patients (91.4%) for group I whereas 33 patients (94.2%) for group II. Early removing of catheter after TVT did not affect operation success rate. It was also associated with a lower incidence of urinary tract infections and lower incidence of positive urine culture. Beside this, there was no adverse outcome like significant rate of recatheterization.

The novel uterus-sparing suture technique was highly effective among patients with placental invasion anomalies.

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Objectives The aim of this study was to evaluate the impact of tension‐free vaginal tape (TVT) on coital incontinence concomitant with stress urinary incontinence. Methods TVT was performed on sexually active women diagnosed with urodynamic stress incontinence (USI) who also experienced coital incontinence with penetration and/or orgasm. The patient‐reported success rate was assessed by the Patient's Global Impression of Improvement (PGI‐I) scale. The sexual function of the women was evaluated by the fulfilled Female Sexual Function Index (FSFI) before and after the operations. Results Eighty‐two women underwent the TVT procedure with epidural anesthesia and 80 of them (97%) answered pre‐operative and post‐operative FSFI questionnaires. In the pre‐operative clinical assessment, 48 women (58%) stated they experienced urinary incontinence during penetration, 13 (15%) during orgasm, and 21 (25%) identified it for both. The patient‐reported success rate was 86% (71 of 82 patients) according to the PGI‐I results: 44 of 48 women (91%) during penetration, nine of 13 (69%) during orgasm, and 18 of 21 (85%) for both. The FSFI scores for sexual desire, lubrication, and sexual arousal domains increased in 57 (71%), 49 (61%), and 44 (55%) patients, respectively, whereas they remained unchanged in 23 (28%), 31 (38%), and 36 (45%) patients. For the orgasm, satisfaction, and pain domains, the results were similar. The mean total FSFI score before the operations was 23.63 ± 6.84 and it significantly increased after surgery to 29.47 ± 4.28 (P < .05). Conclusions The TVT procedure may offer treatment for coital incontinence accompanying USI. It also provides significant improvement in the sexual lives of women.

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Background/Aim: Most women who have completed childbearing request tubal ligation, as it is an effective and irreversible form of contraception. Single incision laparoscopic surgery (SILS) which is currently standard in most surgical specialties, eliminates multiple port incisions and provides faster recovery with better cosmesis. However, there is less data about single incision laparoscopic bilateral tubal ligation. We aimed to compare the results of single-incision-two port laparoscopic tubal ligation and conventional three port laparoscopic tubal ligation. Methods: Patients who desired tubal ligation procedure as a contraceptive method were randomly allocated to two groups as single-incision-two port laparoscopic tubal ligation (Group 1) and conventional three port laparoscopic tubal ligation (Group 2) between April 2015 to January 2020 in the Obstetrics and Gynecology clinics of two university hospitals. A prospective comparative study was conducted, and sixty patients were included in each group, which were compared in terms of operation time, blood loss, length of hospital stay, complications, port site hernia, postoperative pain score, conversion rate, cosmesis and failure of sterilization. Results: There was no need to convert to open surgery in either group. Average blood loss was similar between the groups (107.6 ml vs 98.4 ml, P=0.14). Operating time was significantly longer in group 2 compared to group 1 (38 minutes vs. 26 minutes, P=0.02). Higher pain scores were observed in group 2 compared to group 1 at the 24 th postoperative hour (2.21 vs 3.82, P=0.012). Patients in group 1 were more satisfied with the single incision in the umbilicus based on cosmetic outcome scores (4.88 vs 3.16, P=0.018). There were no reported intraoperative complications in either group. No port site hernias and failure of sterilization were observed in any of the patients. All patients were followed up for a mean of 19 months (range: 12-60 months). Conclusion: Single incision two port laparoscopic tubal ligation does not increase the risk of complications and appears safe. It provides better cosmetic outcomes and lower pain scores compared to conventional laparoscopy.