Transvaginal Tape, also known as TVT, is a minimally invasive procedure that is used in treating urodynamically proven stress urinary incontinence in women. The procedure involves the placement of a small piece of polypropylene mesh (tape) around the pubic bones underneath the urethra.
Transvaginal Tape Procedure
The procedure is normally performed under general anaesthesia, and involves the following steps:
- First, the bladder is catheterised
- The local anaesthetic is inserted into the anterior vaginal wall over the area of the mid-urethra
- The physician makes a small incision in the anterior vaginal wall, and tissue is dissected on either side of the urethra
- A catheter (mounted) is inserted into the bladder to manipulate the bladder during tape insertion.
- At this point, a rigid metal catheter guide is placed into the area where the tissue was dissected.
- The needle containing the transvaginal tape attached to it is inserted into the dissected tissue along with the metal catheter guide and is inserted through the retropubic space along the back of the pubic symphysis.
- The needle emerges suprapubically (above the pubis) onto the abdomen.
- On the other side, an identical technique is followed.
- The physician removes the mounted catheter and performs cystoscopy to check if there is any bladder perforation.
- He/she adjusts the tape bilaterally, ensuring that it is not too tight over the mid-urethra.
- Finally, the incision on the anterior vaginal wall is closed up with dissolvable sutures.
Possible Complications of a Transvaginal Tape Procedure
Just like any other surgical procedure done in a hospital, the TVT procedure can have some possible complications which include:
- Damage to pelvic blood vessels or viscera
- Bladder perforation
- Groin and suprapubic pain
- Vaginal tape erosion
- About 4% of women can have voiding difficulties and urinary retention after the procedure. This is not usually a long-term complication.
- About 3-15% of women can have urgency and frequency symptoms
How Tension-free Vaginal Tape Works
TVT is a surgical procedure that supports a drooping urethra so that when a person coughs or moves vigorously or quickly, the urethra stays closed, and no urine is accidentally released. It’s a straightforward procedure that requires little hospitalisation and recovery time.
What to Expect After Transvaginal Tape Surgery
After the TVT procedure, the patient will be asked to urinate within her hours of surgery to test how the bladder and urethra respond to the surgery. The patient may need a catheter placed into her bladder through the urethra to allow urine to drain while she recovers.
Since the procedure usually causes minimal pain and discomfort, the patient may resume most normal activities in one to two weeks. However, one needs to refrain from sexual intercourse or strenuous activities for 6 weeks, or as advised by the doctor.