الفهرس 
ANATOMY AND PHYSIOLOGYOnly 14 pages are availabe for public view
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Abstract
Our aim in this study was to compare tension-free vaginal tape Secur (TVT Secur) and trans-obturator suburethral tape inside- out technique (TVT-O) for surgical treatment of genuine stress urinary incontinence (SUI) as regard success rate and complications.
This study was conducted at Ahmed Maher Teaching hospital on 50 patients with genuine stress urinary incontinence (SUI). They were divided into two groups: Group I which included 25 patients who were decided to have TVT-Secur done for them and Group II which included 25 patients who were decided to have TVT-O done for them.
All patients were subjected to complete history taking, general and gynecological examination, urodynamic tests, urine analysis, urine culture, random blood sugar, stress test, PVR measurement, quality of life (QoL) questionnaire. Postoperative evaluation was carried out after 1, 3 and 6 months.
Cure was defined as no leakage based on both symptom scale scoring and physical examination. Improvement is defined as ≥50% decrease in symptoms based on the questionnaire’s results .
The TVT-O operation had a shorter surgical duration and longer hospital stay than the TVT-Secur.
There were no serious postoperative complications in both groups. However, TVT-O operation had a higher frequency of complaints and complications compared to TVT Secur as regard urgency, urine retention and vaginal erosion . Both procedure were similar as regard groin pain .The number of women reporting voiding difficulty after the 2 procedures is higher in the TVT-O group.
Anatomical complications like bladder or urethral injury or bleeding of more than 300 ml did not occur in this study.
There were no statistically significant difference between both groups as regard maximum flow rate and post-voiding residual urine volume among both groups. However, there was statistically significant decline in Q-max mainly among TVT-O group.
The study showed that the objective cure rate for the TVT Secur was 56%, 64% and 60% at one month, three months and six months respectively. Whereas the objective cure rate for the TVT-O was 80%, 88% and 88% at one month, three months and six months respectively.
There was significant improvement in ICI-questionnaire score among both groups but the TVT-O procedure significantly decreased SUI reflecting high patient satisfaction post-operative.