Bladder afferent desensitization with capsaicin is promising in patients with motor or sensory bladder dysfunction, although initial pungency might limit its use.
anaesthesia. Patients were considered cured, if they stopped wearing continence pads and improved if the daily number of pads used decreased by at least half. The Incontinence Quality of Life questionnaire and a simple verbal question about patient satisfaction with the surgery were also used and complications were measured.
RESULTSIn all, 40 patients (65%) were cured and 14 (23%) were improved after a mean followup of 28 months. The UI cure rates at 3 and 4 years follow-up were 70% and 66%, respectively. The most common side-effect was transient scrotal or perineal pain or numbness, which affected 12 patients (19%). There was a prolonged postvoid residual urine volume of > 100 mL in six patients (10%), which resolved within 2 weeks of indwelling catheterization. Explantation of the sling was required in two cases (3%) because of infection. In one patient (2%), revision was required for bone-anchor dislodgement.
CONCLUSIONThe InVance sling offers good intermediateterm cure and improvement rates for SUI after prostatectomy. The procedure has an acceptably low rate of minor complications, and should be considered for treating men with less severe forms ( ≤ 5 pads per day) of SUI.
KEYWORDS
Bladder afferent desensitization with capsaicin is promising in patients with motor or sensory bladder dysfunction, although initial pungency might limit its use.
symptoms, incontinence cure rate and the King's Health Questionnaire (KHQ) score were evaluated.
RESULTSThe operative duration was 12 min; the mean pain score was 2.3 and only one patient had transient voiding difficulties. After a mean follow-up of 15 months, 71% of the patients were dry and 14% improved. The KHQ scores decreased significantly for most subscores. Urgency appeared de novo in six patients (5.6%), and vaginal erosion required one TVT-Secur explantation.
CONCLUSIONThis study shows that TVT-Secur is a simple and safe treatment for female SUI, but before recommending this sling as a first choice for treating SUI, TVT-Secur must pass the test of time and comparative studies with conventional slings.
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