Insertion of Tension Free Vaginal Tape
This webpage will give you information about inserting a tension-free vaginal tape (TVT). If you have any questions, you should ask your GP or other relevant health professional.
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?
Having a transobturator tape inserted is a similar operation to TVT, but the tape is placed in a different place.
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) (see figure 1).
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.
What complications can happen?
- Sickness or being sick
- Developing a haematoma
- Infection in the surgical site (wound)
- Unsightly scarring
- Blood clots
- 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 not do any 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.
Inserting a tension-free vaginal tape should prevent you from passing urine in an uncontrolled way.
Author: Mr Jeremy Hawe MBChB MRCOG and Dr Alison Peattie MBChB FRCOG.
Illustrations: Medical Illustration Copyright © 2011 Nucleus Medical Art. All rights reserved. www.nucleusinc.com.
This document is intended for information purposes only and should not replace advice that your relevant health professional would give you.