Inserting a tension-free vaginal tape (TVT)

What is stress incontinence?

Stress incontinence is when urine leaks from your bladder. It usually happens when you do things that place pressure (stress) on your bladder, such as exercise, laughing, coughing and sneezing.

Having weak pelvic-floor muscles is a common cause of stress incontinence. The weakness is usually caused by the muscles being stretched or damaged during childbirth.

Sometimes stress incontinence can be caused or made worse by a weakness in the urinary sphincter. The problem is often made worse if you are overweight or smoke, and tends to get worse with age.

What are the benefits of TVT?

If the operation is successful, urine will no longer leak from your bladder.

Are there any alternatives to TVT?

Simple treatments include pelvic-floor exercises, electrical stimulation, incontinence devices and bladder-neck bulking.

There are other surgical procedures such as Burch colposuspension, needle suspension and having a sling inserted. These are bigger operations than a TVT but are usually no more effective.

What does the operation involve?

Inserting a TVT is usually performed under a local anaesthetic while you are sedated. The operation usually takes about half an hour.

Your doctor will make two small cuts in the lower part of your abdomen and another small cut in your vagina just below your urethra (tube that carries urine from your bladder). They will pass a needle with tape from one side of your urethra and up through one of the cuts made on your abdomen. Your doctor will then pass the needle, with tape, from the other side of your urethra and up through the other cut on your abdomen (see figure 1).

Inserting a tension free vaginal tape 

What complications can happen?

General complications of any operation:

Pain Sickness or feeling sick Bleeding Developing a haematoma Infection of the surgical site (wound) Unsightly scarring Blood clots

Specific complications of this operation:

  • Difficulty passing urine
  • Urine infection
  • Damage to the bladder
  • Damage to surrounding structures
  • Overactive bladder

How soon will I recover?

You should be allowed home after you have passed urine in the normal way, usually later on the same day or the day after. You should be able to return to work after about two to four weeks, depending on your type of work. Your doctor may tell you not to do any manual work at first and you should avoid heavy lifting for a few weeks. Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, you should ask a member of the healthcare team or your GP for advice. You should continue your pelvic-floor exercises to prevent the incontinence coming back and reduce the risk of a prolapse.

Summary

Inserting a tension-free vaginal tape should prevent you from passing urine in an uncontrolled way.

Paying for your procedure

Inserting a tension-free vaginal tape costs are covered by most medical insurance policies, but please check with your insurer first. If you are paying for your own procedure the cost will be explained and confirmed in writing when you book the procedure. Ask the hospital for a quote beforehand, and ensure that this includes the surgeon’s fee, the anaesthetist’s fee and the hospital charge for your procedure.

Acknowledgements 

Author: Mr Jeremy Hawe MBChB MRCOG and Dr Alison Peattie MBChB FRCOG

Illustrations: Hannah Ravenscroft RM

Copyright © 2010 Nucleus Medical Art. This information is produced by EIDO Healthcare Ltd and is licensed by BMI Healthcare. You may not copy, print out, download or otherwise reproduce any of the information other than for your personal, non-commercial use. The information should not replace advice that your relevant health professional would give you.

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