الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
Introduction: Stress urinary incontinence is defined as involuntary loss of urine pre urethra. Investigators have been searching for ways to improve the success rate and avoid failure. Pubovaginal sling have been used to treat female incontinence for many years. TVT is relatively new technique aiming at maintaining continence at the mid urethra. Aim of the work: This study is designed to compare the effectiveness of the tension free vaginal tape (TVT) and auto logous rectus sheath for the treatment of SUI. Patient and Methods: This is a retrospective analysis which was carried out at urology and nephrology center at Mansoura university between Jan 2001 to may 2004. 40 patients were included. 18 patients underwent pubovaginal sling and 22 patients under went TVT. All the patients underwent history taking, physical examination, lab. Investigation, routen radiology and invasine urodynamic. All were operated by one surgeon. One week, 3 months, 6 months follow up was done to evaluate the out come of the operation in both group by taking the patients symptom score and measuring, PVR, and doing invasive urodynamics. Results: The preoperative parameters were comparable in both groups. The operative time was longer with significant difference in the pubovoginal sling group. While the operative time was shorter in TVT group. There was significant improvement as regarding PRV in the TVT group during 3 and 6 months follow up. Urinary retention occurred in 4 patient out of 18 insling group while no case of urinary retention in TVT group. There was one case of bladder injury in each group. There was significant improvement in each group as regarding the detrosur pressure at maximum flow as well as in the functional length during 3 and 6 months follow up during the urodynamic investigation with no significant difference in other urodynamic parameters. Conclusion: Both techniques are durable and achieved success rate up to 92.5%. With no significant difference in urodynamic follow up in both groups. Sling technique needs more experienced operater while TVT easy to perform with short learning curve. It is hoped that better understanding of factors that influence surgical success will translate into continued refinement of those techniques.