Surgery for Stress Urinary Incontinence

Tension-free Vaginal Tape Sling Procedure

Tension-Free Vaginal Tape (TVT) placement is a vaginal procedure used to correct stress urinary incontinence and a disorder called intrinsic sphincter defect. Through a small vaginal incision, permanent mesh-like material is placed underneath the urethra and anchored to the abdominal muscles above the pubic bone.

The mesh-like material remains as a permanent sling under the urethra, preventing incontinence when straining or coughing.

In some cases, the bladder may be “tacked” into place using a procedure called an anterior repair. General anesthesia (going to sleep) or local anesthesia (numbing injection) is required. If not performed with other procedures, patients may go home the same day or the next morning.

TVT in white courses under urethra preventing loss of urine when bearing down.

Benefits include:

• Less invasive Less pain Durable results (84 -95% success rate) Small incisions Local anesthesia Same day or overnight surgery stay
• Return to work in 7-10 days

• Indication:Stress urinary incontinence or ISD
• Approach: Small vaginal incision
• Anesthesia: Local (awake with numbing injection) or General (go to sleep)
• Invasive: Minimally invasive with only 30 minutes OR time
• Hospitalization: Sameday or overnight
• Recovery: Usually 2 -3 weeks

Frequently Asked Questions

What is TVT?

The Tension-Free Vaginal Tape is a ribbon on mesh material made from a specific plastic (Prolene) whose mid-portion goes underneath the urethra and ends adheres to the lower abdominal wall & muscles. This ribbon or tape causes to the urethra to close when the patient strains, laughs, coughs otherwise puts pressure on the bladder. As a result episodes of incontinence are prevented.

Who is a candidate for TVT?

• Women with incontinence due to stress urinary incontinence OR intrinsic sphincter defects AND Women healthy enough for surgery Women with no local infection
• Women NOT on anticoagulation therapy

How well does TVT work?

In a three year study, 86% of women were completely cured with another 11% significantly improved.

(Ulmsten et al, “A three-year follow up of tension free vaginal tape for surgical treatment of female stress urinary incontinence”, Br J Obstet Gynecol 1999 April:106(4) pp345-350.)

How long does TVT surgery take?

Typical operating room time is 30-35 minutes, if no other procedures are performed.