Tension-Free Vaginal Tape (TVT) for stress incontinence

Scientific Editor: Editorial Board ISUD website

What is a Tension-Free Vaginal Tape (TVT)?

Tension-Free Vaginal Tape (TVT) is a synthetic tape that is placed in women to support the urethra, in order to prevent stress urinary incontinence, else known as effort urinary incontinence (i.e. urine loss while coughing, exercising, sneezing etc).

When is it placed?

TVT is indicated to be placed in women with non-complex stress/effort incontinence, i.e. when there is no bladder prolapse and no neurological disease affecting their condition.

What sort of preparation is required?

Upon hospital admission, preoperative preparation includes blood tests, chest X-ray and ECG (electrocardiogram). In case you are on anticoagulant therapy, it may be required to interrupt your anticoagulant therapy a few days before the operation. You should always consult your Cardiologist, for there may be need to replace anticoagulants with injections in the abdominal region.

How is it placed?

The procedure requires general or spinal anesthesia. In the beginning, the woman is placed in the gynecological examination position, the region is cleansed and a catheter is inserted in the bladder. TVT is inserted through an incision that is made at the anterior vaginal wall, in order to support the urethra and keep it in the right position. At the end of the procedure, some gauze is placed in the vagina to act as a bandage for 24 hours and is removed the next day. Hospital stay is about 2 days.

The catheter is usually removed on the first postoperative day.

Two out of three women will have no incontinence problem at all after surgery, and only one will report some small urine loss.

What about after placing it?

During the first postoperative days, the patient may feel a burning sensation in the urethra. Also, the catheter may cause bladder spasm and intense pain, which lasts only a few seconds but recurs at regular time intervals. These symptoms can improve with appropriate pharmaceutical agents.

Once the catheter is removed, the patient’s urinary function is checked. An unltrasound is performed to make sure there is no post-void residual urine (i.e. no urine left in the bladder after voiding).

Upon discharge from hospital, you will be given specific written instructions about::

  • what antibiotic regimen to take
  • how long to abstain from physical strain
  • how important it is to drink plenty of fluids

You should necessarily consult your Cardiologist about when to restart your previous anticoagulant treatment.

What is the effect on patient’s quality of life?

Most women do not face any problem after having TVT placed. In less than 1/10 of patients, there may occur pain in the thighs (treated with common analgesics), persistent incontinence and incomplete bladder voiding with reduced urine flow.

With regard to nutrition after surgery, you should receive about 1.500ml fluids/day and avoid coffee, alcohol and smoking, for they may cause irritative symptoms.