Tratamiento de la incontinencia urinaria de esfuerzo con el sistema TVT: Complicaciones en nuestros primeros 100 casos

introduction: the tvt system is the most common surgical technique of female stress urinary incontinence, because of the simplicity, good clinical results and rare complications. material and methods: from april, 1999 to march, 2004, it has been done in our department 100 tvt systems with the revision of the result over the six following months. the average follow-up rate was 10, 36 months (r: 1-54 months) and looses mean the 11% of the cases. all the patients presented stress incontinence and their average age was 56,6 years old (30-80). the 12% of the cases have been previously operated of urinary incontinence. 21 patients presented previous surgery of pelvic floor. in the 17% of the cases, tvt systems was associated to another surgical technique: 15% of them was operated of cystocele, 1% of them had surgical correction of rectocele, 1% of them had a strong surgery of pelvic floor, that included tvt system, correction of pelvic floor and hysterectomy. results: we obtained 65% of successful cases, defined as objective confirmation of absence of looses from the observer and the subjective reference of the patient; 17% of clear improvement (clear decrease of looses from the patient and subjective improvement) and 7% of failure of the technique. the total percentage of appearance of novo post-surgery urgency is 9%. there were complications in the 12% of the cases: there were three cases of bladder perforation, two of them intra-operative and one of them deferred and associated to an infection of surgical wound; another three cases of residue in the immediate post-operative that were resolved with bladder catheterization; one case of acute urinary retention that was treated with bladder catheterization with suprapubic cistostomy; one case of chemical peritonitis corrected with a conservative treatment; two cases of vaginal extrusion of sling, which were resolved with the section of the outer sling; one patient presented a hipogastric hematoma resolved with conservative