338 an article on 110 patients with a dry rate of 70.4% at 2 months [16]. This report actually revealed a low cure rate compared with conventional midurethral slings, but the technique was the Hammock technique in 85.5%. More re- cently, Oliveira et al reported, in January of 2009, good suc- cess rates in 107 patients with a mean follow-up of 15 months. The patients were either dry or improved in 85% [17]. In our study, the overall cure or improvement rate was 93.5% at 1 month after TVT-S and 86.8% at 2 years after TVT-S. Oliveira et al reported that the cure rate was 83% after TVT-O, 67% after TVT-S, and 87% after Mini-Arc [18]. The fact that TVT-S has been associated with lower success rates deserves some consideration. TVT-S has a long learn- ing curve. Even among experienced surgeons, consistent positioning of the TVT-S tip maybe difficult. Moreover, mesh detachment from the introducer blades requires a twisting movement that may enlarge the internal ob- turator muscle area where the TVT-S tip is inserted, thus compromising mesh adhesion [18]. But, according to Jeong et al, there was no significant difference in cure rate or pa- tient satisfaction between the TVT-S and MONARC proce- dures after more than 1 year of follow-up [4]. In our study, the TVT-S procedure was shown to offer relatively good re- sults and a significant improvement in quality of life among women with SUI. 　Because the questionnaire is a subjective measure, it should be convenient and easily understood. The I-QoL is easily self-administered and takes approximately 5 mi- nutes for the average patient reading at a fifth-grade level to complete [19]. It is available in 16 different language ver- sions and has been validated in four European countries as well as in the United States [20]. Also, we used the Korean version of the I-QoL. The I-QoL questionnaire is a targeted condition-specific questionnaire that assesses the effect and distress of specific symptoms of SUI [21,22]. The I-QoL contains 22 items, each with a five-point, Likert-type re- sponse scale, yielding a total score and three subscale scores. The potential advantage of the I-QoL over previous measures is its applicability to patients over a range of ages and with varying types and severities of SUI. 　In our study, based on the outcome of the I-QoL, the pa- tients experienced a significant improvement in their qual- ity of life with the TVT-S procedure. CONCLUSIONS The TVT-S procedure has a cure rate similar to that of the current TVT or TOT procedures, and the TVT-S procedure can be performed safely. From our experience, the TVT-S procedure offers a good success rate and a significant im- provement in quality of life among women with SUI. We suggest that the TVT-S procedure is an efficient surgical treatment for improving the aspect of the quality of life of patients as well as SUI itself. However, controversy re- mains about the difference in success rates of the TVT-S procedures between medical centers. Also, the TVT-S pro- cedure has a long learning curve. Korean J Urol 2011;52:335-339 Shin et al Conflicts of Interest The authors have nothing to disclose. REFERENCES 1. Minassian VA, Stewart WF, Wood GC. Urinary incontinence in women: variation in prevalence estimates and risk factors. Obstet Gynecol 2008;111:324-31. 2. Dmochowski RR, Blaivas JM, Gormley EA, Juma S, Karram MM, Lightner DJ, et al. Update of AUA guideline on the surgical man- agement of female stress urinary incontinence. J Urol 2010;183: 1906-14. 3. Atherton MJ, Stanton SL. The tension-free vaginal tape reviewed: an evidence-based review from inception to current status. BJOG 2005;112:534-46. 4. Jeong MY, Kim SJ, Kim HS, Koh JS, Kim JC. Comparison of effi- cacy and satisfaction between the TVT-SECURⓇ and MONARCⓇ procedures for the treatment of female stress urinary inconti- nence. Korean J Urol 2010;51:767-71. 5. Leach GE, Dmochowski RR, Appell RA, Blaivas JG, Hadley HR, Luber KM, et al. Female Stress Urinary Incontinence Clinical Guidelines Panel summary report on surgical management of fe- male stress urinary incontinence. The American Urological Association. J Urol 1997;158:875-80. 6. Mainprize TC, Drutz HP. The Marshall-Marchetti-Krantz proce- dure: a critical review. Obstet Gynecol Surv 1988;43:724-9. 7. Galloway NT, Davies N, Stephenson TP. The complications of colposuspension. Br J Urol 1987;60:122-4. 8. Kobashi KC, Govier FE. Perioperative complications: the first 140 polypropylene pubovaginal slings. J Urol 2003;170:1918-21. 9. Delorme E. Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women. Prog Urol 2001;11:1306-13. 10. Daneshgari F, Kong W, Swartz M. Complications of mid urethral slings: important outcomes for future clinical trials. J Urol 2008;180:1890-7. 11. de Leval J. Novel surgical technique for the treatment of female stress urinary incontinence: transobturator vaginal tape in- side-out. Eur Urol 2003;44:724-30. 12. Neuman M. TVT and TVT-obturator: comparison of two operative procedures. Eur J Obstet Gynecol Reprod Biol 2007;131:89-92. 13. Neuman M. Perioperative complications and early follow-up with 100 TVT-SECUR procedures. J Minim Invasive Gynecol 2008;15: 480-4. 14. Gagnon LO, Tu le M. Better short-term outcomes with the U-method compared with the Hammock technique for the implantation of the TVT-SECUR under local anesthesia. Urology 2010;75:1060-4. 15. Martan A, Masata J, Svabík K. TVT SECUR System--tension-free support of the urethra in women suffering from stress urinary in- continence--technique and initial experience. Ceska Gynekol 2007;72:42-9. 16. Debodinance P, Lagrange E, Amblard J, Lenoble C, Lucot JP, Villet R, et al. TVT Secur: more and more minimally invasive. Preliminary prospective study of 110 cases. J Gynecol Obstet Biol Reprod (Paris) 2008;37:229-36. 17. Oliveira R, Silva A, Pinto R, Silva J, Silva C, Guimarães M, et al. Short-term assessment of a tension-free vaginal tape for treating female stress urinary incontinence. BJU Int 2009;104:225-8. 18. Oliveira R, Botelho F, Silva P, Resende A, Silva C, Dinis P, et al. Exploratory study assessing efficacy and complications of TVT-O, TVT-Secur, and Mini-Arc: results at 12-month follow-up. Eur Urol 2001;Epub ahead of print