New Techniques in Urogynecology

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Dr. Richard Scotti:  “Hello, I am Dr. Richard Scotti, the Division Director for Urogynecology for OBGYN.net.  We’re here at the International Federation of Gynecologists and Obstetricians in Washington, D.C.  This is an International Meeting, and I have the privilege of interviewing our international guest Professor Mauro Cervigni from Rome, Italy who is a noted Urogynecologist.  I would like to ask him a couple of questions about some of the new technologies and some of the things that he’s engaged in.  Good morning, Professor Cervigni, I know that you’ve been very involved in some of the newer concepts in the treatment of urinary incontinence in women, perhaps, you might want to let our listenership know exactly what you’re doing and why you have embraced this new philosophy.”

Dr. M. Cervigni:  “Yes, the treatment of stress urinary incontinence has been changing because it evolved to a mini invasive approach just to treat the problem of incontinence in women.  The mini invasive approach has many advantages, one is that it is a day case procedure that can be performed one day as an outpatient procedure.  The patient can leave the hospital the next day from the operation and get back to their own normal daily activity in a week.  This is very important for women that are very active and suffer from this kind of benign pathology, which is extremely distressful for women.  This mini invasive approach consists of inserting a very short tape below the urethra which is the canal that brings the urine outside from the bladder and then creating a kind of reconstruction of the urethra in which when women go on to their activities like lifting some weight, coughing, or jumping, there is no more leakage of urine.”

Dr. Richard Scotti:  “Now I was privileged to be with you in Rome and observe you do some of these procedures and began doing them myself here.  I know that there are quite a number of American practitioners that now use this procedure, which is known as the TVT – tension free vaginal tape; it certainly is a breakthrough.  How long does it take you to do one of these and how does that compare to the methods that you were doing prior to this new development?”

Dr. M. Cervigni:  “Yes, this is a real new advancement in the sense of the treatment because the procedure is very short, it lasts no more than twenty minutes, and it can be performed under local anesthesia without any general anesthesia so the patient is awake.  This is an important advantage because a woman can cough so it’s possible to modulate the exact tension of the tape below the bladder so it is a way to exactly assess the real function of the bladder.  The old treatments like the traditional one, the open procedure with general anesthesia, can create some problem in the post-operative period in that women sometimes have problems of voiding - they have difficulty urinating.  With this new approach, thanks to the loosely positioning of the tape, the woman can immediately start to urinate without any problems.”

Dr. Richard Scotti:  “I appreciate your input, Professor, and I think we’re just about out of time.  We look forward to seeing what the long term results are; I think now we’re up to about five years with some fairly good 85%-90% or so success rate which certainly compares favorably with other methods so thank you very much for your time.”

Dr. M. Cervigni:  “You’re welcome.”

Dr. Richard Scotti:  “We’ll see you in Rome at the International Urogynecology Association meeting.”

Dr. M. Cervigni:  “Thank you very much.”

Dr. Richard Scotti:  “Dr. Cervigni is chairing the next meeting of the International Urogynecology Association which will be held in Rome, Italy from October 21-25, 2000.  Thank you, Mauro.”

Dr. M. Cervigni

:  “You’re welcome.”