Tension-Free Vaginal Tape Operation in Stress Urinary Incontinence: Comparison between Local Versus General Anesthesia Groups

Jung, Ji Hak; Shin, Myung Sik

Abstract

PURPOSE: To assess the differences between local and general anesthesia, with the tension-free vaginal tape (TVT) operation, in relation to the clinical outcome, surgical complications and degree of satisfaction of women with stress incontinence.
MATERIALS AND METHODS
A nonrandomized, retrospective study was performed on 65 patients having undergone a tension-free vaginal tape operation between April 1999 and June 2001. After explaining the anesthetic procedure to the patients, 35 did not want to be admitted, so chose local anesthesia, with the other 30 choosing general anesthesia. The clinical outcomes of the operation were evaluated by telephone interviews, and the definition of success or failure determined by Stamey's criteria.
RESULTS
The mean follow-up periods of the patients with local and general anesthesia were 14.2 (6.1-31.3) and 12.6 (6.4-30.7) months, respectively. The success rates with local and general anesthesia were 94.2 and 96.6%, respectively, with no significant difference between the two groups. The mean post-void residual urine volumes were 51.6 (8-210) and 47.4 (5-180)ml, respectively, and the indwelling periods of the Foley catheter were 1.9 (1.1-12.8) and 2.2 (1.3-11.5) days, respectively. Bladder perforations occurred in 2 patients under local anesthesia and in 3 under general anesthesia, which was cured by an indwelling catheter over a 2 day period.
CONCLUSIONS
The TVT procedure was a very effective and safe surgical treatment for female stress urinary incontinence, and there were no differences in the success rates and surgical complications between anesthesia groups. Considering the cost and admission period, local anesthesia may be better than general anesthesia, but a longer-term follow-up will be required.