Objective To evaluate the effectiveness and indications of a new minimally invasive surgical procedure,the tension-free vaginal tape-SECUR (TVT-S),in the treatment of female stress urinary incontinence (SUI). Methods Twenty-seven consecutive women with stress urinary incontinence underwent the procedure under local anesthesia.The mean age of the study group was 51 (range 25-69)years,average disease duration was 7 (1-20) years.In one case,repair of pelvic floor defects had been made previously.According to the pelvic organ prolapse quantitive(POP-Q) (American College of Obstetrics and Gynecology),the Aa＞-1 cm.Swab tests have shown that the angle of urethra Was greater than 60 degrees,while the evaluation of clinical symptoms were grade Ⅱ.The urodynamie test preoperatively of 27 cases display that bladder compliance was normal,mean maximum urethral closure pressure was 40cm H2O(25-60 cm H2O),and VLPP was greater than 60 cm H2O.Minimum follow up was three months (range 3-15 months).The pre-operative maximal urethral cloSHre pressure (MUCP) of all patients was above 30 cm H2O.Ninety-six percent of patients had pure USI,one patient had mixed urodynamic incontinence (MUI).Collection of the data included operative time a well as pre-and post-operative complications.Patients were post-operatively assessed by a validated urinary incontinence-specific measure of Quality of Life (QoL) questionnaire which was completed by all patients at least three months after surgery. Results All patients who underwent the procedure were under local anesthesia.Of these patients,4 cases (MUCP＜30 cm H2O) underwent TVT-S with U position while the other 23 underwent TVT-S with Hammock position.The mean operation time was 8 minutes (range 6-15 min) and blood loss during operation was about 10 ml.There were no urethral and bladder injuries during the procedure.Postoperative indwelling duration was 0-1 day.After follow-up,26 patients were cured without pad usage and 1 with mixed UI had prominent improvement in urgency incontinence symptoms.The quality of life was also improved significantly.93 % patients were satisfied with the postoperative improvement in urinary incontinence symptoms,and the more severe preoperative symptoms the higher satisfaction rate postoperatively. Conclusions TVT-S iS a safe,effective and minimally invasive procedure for SUI with less complication.The patients with normal bladder compliance and MUCP,urethral hypermobility are indicated for this surgery,some elderly patients or patients with low urethral pressure were proposed to undergo U position TVT-S or TVT.

OBJECTIVE:To establish the quality standard for Mian medicine Indigofera stachyoides. METHODS:Medicinal properties and microscopic characteristics were identified;TLC was used for the qualitative identification;HPLC was conducted for content determination of epicatechin and 2α,3α-epoxy-5,7,3′,4′-tetra-hydroxy-flavan-(4β→8)-epicatechin(reference A):the col-umn was Comatex TM C18 with mobile phase of acetonitrile- water at a flow rate of 1.0 ml/min,and detection wavelength was 210 nm,column temperature was 30 ℃,injection volume was 5 μl. RESULTS:It showed clear microscopic identification map. I. stachyoides TLC had clear spots and well separated. The linear range was 0.274 5-4.392 0 μg (r=0.999 6) for epicatechin,and 0.103 0-1.648 3 μg for reference A(r=0.999 4),RSDs of precision,stability and reproducibility tests were lower than 3%,recov-eries were 99.76%-104.82%(RSD=2.42%,n=6) and 97.98%-104.99%(RSD=2.75%,n=6) respectively. CONCLUSIONS:The established standard can be used for the quality control of I. stachyoides.