Stress Urinary Incontinence Clinical Trial
Official title:
Time Interval Between TVT and First Void (TIBT) Study
The primary aim of this study is to compare, in women undergoing tension-free vaginal tape (TVT) insertion under sedation and local anaesthetic infiltration, the time interval of first void following surgery between a group of patients who received intravenous fluids to those who did not.
Urinary incontinence is a global condition and its prevalence increases with age. It impairs
quality of life of patients and has a significant burden on the health care system. Stress
urinary incontinence (SUI) is defined as involuntary leakage of urine when there is an
increase in pressure on the bladder, i.e. during exercise, coughing or sneezing. It is the
commonest form of urinary incontinence and affects around 50% of women with symptoms of
incontinence.
The development of mid urethral tapes (e.g. the tension free vaginal tape [TVT]) in 1998 has
greatly changed clinical practice. The introduction of TVTs has reduced the average length of
hospital stay for patients undergoing surgical treatment of SUI by over 50%. As a result, the
hospital bed occupancy for the treatment of SUI has decreased by a similar amount. Studies
have shown it to have similar effectiveness to the main alternative surgical treatments in
SUI.
In Gloucestershire Royal Hospital, we perform the procedure as a daycase with local
anaesthetic infiltration under sedation. Routine cystoscopy is performed as a part of the
procedure to exclude bladder trauma. The bladder is emptied at the end of procedure. Patients
are then allowed to drink as normal and post void residuals are checked before discharge to
rule out any problems emptying the bladder. It has been observed that the major limiting
factor in early discharge of patients is the time to first void following surgery. As the
patients are starved for surgery, they are often dehydrated and therefore require enough oral
fluids to rehydrate and fill their bladder in order to void. If we can somehow reduce this
waiting period, we can discharge patients sooner improving their experience with the surgery.
We would like to examine whether filling up the bladder intra-operatively with intravenous
fluid will reduce this time limiting step.
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