North Bay Ontario

A TVT (or a "Tension free Transvaginal Tape" placement) is a minimally invasive surgical procedure that is used to help women with stress urinary incontinence.  There are two techniques for placement of the tape, the traditional retropubic TVT and the transvaginal obturator tape placement (also sometimes called a TVTO).  The goal of both of these techniques are the same, to provide a tension free tape underneath the urethra with the goal of reducing stress urinary incontinence.  


The Procedure

Please arrive at the day surgery unit on time. You can expect to be at the hospital for several hours; however the surgery itself will last between 1-2 hours.  The tape is deployed with a specialized device and is a one-time use sterile tape.  


Risks

All surgical procedures have inherent risks associated with them.  Despite these risks being very low, we believe it is important that all patients who choose a surgical option are aware of the potential for unwanted outcomes.

TVT is a very safe procedure, however, the risks do include anesthetic complications such as MI, Stroke, adverse drug reaction, or even death.  Specific to the surgery, blood loss and the need for a transfusion are a real, but very small risk.  Difficulty voiding and the need for a catheter can occur. Urinary overactivity is a common side effect of this surgery that usually resolves with time. Perforation of the bladder or urethra can occur and can require replacement of the tape.  For this reason, at the end of the surgery a cystoscopy is performing before waking from anesthesia.  Prolonged leg pain can also rarely occur due to compression of nerves by the tape.  Very rarely, the tape can erode into the urethra or bladder and require surgical excision.   


When you arrive

A general anesthetic or a regional anesthetic (such as a spinal that numbs below the level of the block) will be administered by the Anesthetist. Once frozen or asleep you will be placed into a lithotomy position and a small incision will be made in the anterior wall of the vagina.  Through this incision, with the aid of a specialize deployment device, the tape will be placed in a tension-free fashion to lift the position of the urethra and reduce stress urinary incontinence.  At the end of the procedure a rigid camera will be gently inserted into the urethra with the aid of lubrication.  This is done to confirm that the bladder and urethra have not been perforated by the tape.     ​

After TVT

After the TVT you will be brought to the recovery area.  Sometimes a packing will be placed in the vagina for a few hours after the surgery and this will be removed in the recovery unit.  Prior to discharge you will undergo a "trial of void".  This is to ensure that the tape is not so tight as to prevent urination.  Very rarely a catheter must be placed because the patient is unable to void temporarily after the procedure is completed.  

You will be able to resume normal light activities including driving within a few days.  Most patients do not complain of significant pain following the surgery, however discomfort with voiding can be expected for a few weeks.  Pain medications are rarely needed for more than a few days. 
If is important to not perform any significant squatting for 6 weeks following the surgery as this can move the location of the tape before it has a chance to scar into place.  This can diminish how effect the procedure will be in reducing stress urinary incontinence.  


When Should I Call my Doctor?

You should contact our office if significant bleeding or burning persists for more then a few days, if you are having a hard time passing your urine, or if you develop a fever.

Q&A

1. What is a TVT tape?

     A Tension-free Transvaginal tape is a synthetic mesh that is inserted to provide support to the urethra to reduce stress urinary incontinence.  It does not resolve urge incontinence, however in patients with "mixed" incontinence (both stress and urge incontinence) it can be used to help the "stress" side of the problem.  

2. Will it hurt?

     The procedure should not be uncomfortable and is performed under either a regional or general anesthetic.  You may feel pressure, burning, or an urge to urinate, but the pain should be managed with oral pain medication for a few days following the surgery.

3. How long will it take?

     The procedure length is usually under 1 hour.  You will be able to go home the same day, but expect to be at the hospital for several hours.

4. What about the FDA warning I have heard about?

    While there is an inherent risk with the placement of any foreign body during surgery, these risks are very small.  We believe patients should be educated on the risks of surgery before preceding.  The risk of mesh erosion is a real risk, however this risk is very small.  Additionally, the main concerns involving pelvic mesh have been with regards to pelvic organ prolapse rather than stress urinary incontinence.  Population data has suggested TVT meshes are safe and have excellent patient satisfaction outcome results.  Please feel free to ask any questions you may have.

TVT

​Tension free Transvaginal tape

Urology North

Call Us:  +1-705-995-2490