The TVT Sling operation

TVT stands for Tension-free Vagina Tape or Trans Vaginal Tape. The procedure can be carried out using a local anaesthetic. It is a mesh-like tape that is surgically inserted through the vagina to support the bladder neck and urethra. If you undergo TVT surgery, your surgeon will restore the normal position of the urethra by weaving or placing a "sling" or mesh tape beneath it. Uniquely, TVT provides support at the middle of the urethra, the section that is under the most strain during normal activities. Placing the TVT in this area, therefore, helps restore this part of the urethra, which is instrumental to the urination process, to a more natural position. Unlike other procedures, no bone anchors or sutures are necessary.

Female stress urinary incontinence (SUI) is generally caused by the urethra not functioning properly. Unlike other types of incontinence, SUI is not a problem of the bladder. Normally, the urethra, when properly supported by strong pelvic floor muscles and healthy connective tissue, maintains a tight seal to prevent involuntary loss of urine. When a woman suffers from the most common form of stress urinary incontinence, however, weakened muscle and pelvic tissues are unable to adequately support the urethra in its correct position. As a result, during normal movement as pressure is exerted on the bladder from the diaphragm, the urethra cannot retain its seal, permitting urine to escape.

The TVT system uses a surgical procedure known as the sling, to correct SUI. The mesh is positioned underneath the urethra, creating a supportive sling. When pressure is exerted, such as during a cough or sneeze, the TVT sling tape provides the support needed by the urethra, allowing it to keep its seal. Tension-free vaginal tape procedure is not done for pregnant women or for women who have a urinary tract infection.

Normally the operation should take around 20-40 minutes.

After Surgery

Usually within hours of your surgery, you will be asked to urinate to test the response of your bladder and urethra to the surgery. You may be released to go home the same day as your surgery, if everything looks normal you will probably leave hospital the same day. It may be necessary to have a catheter placed into your bladder through your urethra to allow urine to drain while you recover or to teach you to perform self-catheterization temporarily.
TVT surgery usually causes minimal pain and discomfort.  You may resume most normal activities within 1 to 2 weeks, however it is advised not to drive for 2 weeks and not to have sexual intercourse or strenuous activities for 6 weeks.

What is the success rate?

Tension-free vaginal tape surgery can be an effective for stress incontinence.  study reported a cure rate between 85% and 87%, with an additional 4.5% to 7% of participants reporting improvement in symptoms. TVT appears to be a safe and effective treatment for obese women.

Risks

As with all surgery there is the possibility of risk of infections or other complications.The risk of bladder puncture appears to be higher from the TVT procedure than from other treatments for stress incontinence; however, this sort of injury is often relatively minor. Some women may experience either retention of urine or urgency to urinate after TVT surgery.

What's new?

Transobturator (TOT) surgery is similar to TVT surgery, but due to the newness results can not yet prove whether it is safe and long-lasting.

Something to think about.

As with any surgery, you are placing your trust in the surgeon who is carrying out the procedure. Never be afraid to ask the surgeon, if it will be him or his understudy performing the operation. How much success has the doctor had in treating this type of operation; the success of surgical procedures for urinary incontinence depends on the experience and skill of the surgeon.
It is your body, you have the right to find out as much as information as possible.