Comparative study of the LIFT® and the TVT® procedure in the surgical treatment of the female stress urinary incontinence

Aims. -The purpose of the study was to compare a polyester mesh coated with silicone (LIFT (R), Cousin) to a polypropylene mesh (TVT (R), Gynecare), in terms of results, and short and middle term complications. Material and methods. -We have performed a retrospective study concerning 140 patients between 2000 and 2002 (71 LIFT (R) and 69 TVT (R)) operated for stress incontinence with or without vaginal surgery (prolapse surgery or hysterectomy). We noticed per- and postoperative complications. The patients were contacted by phone to evaluate the middle and long-term results. Results. -The mean age of the patients were of 58.8 +/- 11.3 years in LIFT (R) group and 57.2 +/- 7.5 years in TVT (R) group. More intraoperative complications arose in the TVT (R) group (six bladder injuries and three haemorrhages versus two in LIFT (R) group, p < 0.05). There was no difference for the postoperative time. The mean follow-up was 16.6 +/- 5.7 months for the LIFT (R) and 32.2 +/- 11.3 months for the TVT (R). 80% of the patients were dry in the LIFT (R) and 75.8% in the TVT group. There was no significant difference concerning the rate of de novo urge incontinence (18.3 versus 17.7%) and voiding difficulties (10 versus 16%). On the other hand, 6.7% of the patients of the group LIFT (R) presented bad heating with prosthesis exposure, in every case a partial resection of the mesh was performed. We did not observe any case of exposure in the TVT (R) group. Conclusion. -The LIFT (R) seems as effective as the TVT (R) with a rate of de novo urge incontinence and voiding difficulties similar to the TVT (R) and to the Literature's data. However the rate of 6.7% of exposure leads us to prefer polypropylene meshes. (c) 2007 Elsevier Masson SAS. Taus droits reserves.