New Technique for Correcting Both Incontinence and Cystocele: T.I.C.T. (Tension-Free Incontinence Cystocele Treatment)

Abstract

The purpose of this retrospective study is to evaluate the safety and the efficacy of a new surgical procedure for correcting both incontinence and cystocele. This method of Tension-free Incontinence Cystocele Treatment (T.I.C.T.) consists in using a polypropylene fly shaped mesh made up of a central body (positioned under both the urethra and the bladder) and two wings (which cross the Retzius and reach the suprapubic area after being pulled up with a modified Stamey needle, under digital control). Seventy patients with stress urinary incontinence and severe cystocele underwent the T.I.C.T. procedure. Their mean age was 56 years (range 40-78), the average follow up was 18 months (range 2-36 months). The objective cure rate was 90% for incontinence and 94.3% for cystocele. No intra-operative complications occurred. Postoperative complications included 2 cases (3%) of voiding difficulty, one case of de novo instability, and one case of erosion and granuloma. Neither bladder perforation nor vascular damage was found. These data show the low risks and the good results of this treatment

Mini-invasive tension-free surgery for female urinary incontinence

“…It consists of two curved stainless steel needles attached to a prolene mesh sling sheathed in plastic, a detachable handle to facilitate retropubic passage of the needles. Variations include needles designed to be passed from the suprapubic incisions into the vaginal incision, where the tape is picked up and passed through the space of Retzius (15).…”

How to prevent mesh erosion in transobturator Tension-Free Incontinence Cystocoele Treatment (TICT): a comparative survey

“…Several options exist for the treatment of SUI and cystocele including pelvic floor muscle exercises, pessary, and surgery. Tension-Free Incontinence Cystocoele Treatment (TICT) was introduced by Leanza-Gasbarro-Caschetto in 2001, on the basis of experimental and clinical investigations to obtain a physiologic mechanism of closure and opening of the urethra in the event of genuine SUI and cystocoele (10). TICT took origin from the previous retropubic tension-free vaginal tape (TVT) based on the integral theory according which mid-urethra has a main role for urinary continence but differs in that the former restores the anatomy and physiology of the entire anterior compartment (11).…”