Tension free vaginal tape

In some people, if stress incontinence does not sufficiently improve with the other more conservative treatments, that is when you may wish to consider surgery. Every person is different, and a surgeon will be able to discuss with you what exactly is causing your problem, and how surgery may help. Whatever your particular condition, it is important to really think through the pros and cons of having surgery.

If your doctor or nurse refers you to see a surgeon, then this is an ideal time to ask lots of questions. Ask your doctor as many questions as you want, and never be afraid to go back or telephone to get more information or a clearer explanation. Before meeting the surgeon it may help to note down your questions on a piece of paper, so you don’t forget what you wanted to ask. Make sure you write down the answers you are given; it’s easy to come out of a consultation and forget what has been said.

At any stage of the process if you are not clear about anything the doctor or surgeon says, ask them to explain again, a bit slower this time. The surgeon can also explain why they consider one operation particularly suitable for you.

Tension-free vaginal tape (TVT) is for women with stress urinary incontinence. It is usually not considered suitable for women considering having children, or for women with other conditions like a cystocele or a vaginal prolapse.

The procedure can be done as day surgery, with only a local anaesthetic so the patient is fully conscious although some surgeons do perform this under general anaesthetic. Although recovery time after the operation is less than some operations for this problem, it should not be considered a minor procedure.

During the operation the tape is inserted through a small incision in the vaginal wall. It lies between the vagina and the urethra, so it supports the middle of the urethra. Each end of the tape is threaded through two small holes on the abdomen just above the pubic bone. This support reduces the effect of any sudden increase in abdominal pressure (coughing, sneezing) that causes stress incontinence.

Sometimes there can be problems associated with this operation: bleeding, injury to the bladder, difficulty emptying the bladder, urgency, and urinary tract infections. In addition tape erosion is a small possibility. Long-term success rates and side effects are yet to be identified.

The 5-year post-treatment success rates for TVT have been confirmed to be 84.5% for pure SUI, 67% for the mixed incontinence cases, and 72.2% for cases when associated with sphincter deficiency. (UKPUBMED central)

If you would like more information about this procedure, please make an appointment with your GP who can discuss options with you or refer you to a consultant if appropriate.