Tension – Free Vaginal Tape (TVT)
GYNECARE® TVT (tension-free vaginal tape) is a synthetic mesh tape that prevents urine leakage during sudden movement (e.g., laughing, coughing, sneezing) and while exercising by reinforcing the ligaments and tissues that support the urethra. This minimally invasive procedure is used to correct stress incontinence and combined stress and urge incontinence in women.
The tape is placed beneath the middle of the urethra in an outpatient surgical procedure that takes 30 to 50 minutes to perform. The procedure is performed under local, regional, or general anesthesia and does not require a urinary catheter. If local or regional anesthesia is used, adjustments can be made during the procedure to ensure that adequate support is provided. Cystoscopy is performed to make sure there has been no injury to the bladder during the procedure. Gynecare TVT does not require anchors or sutures and produces minimal scarring. Placement of the tape may be performed by the surgeon through an abdominal approach or a vaginal approach, depending on the physician’s preference.
Recently, a TVT Obturator System has been developed. This new mid-urethral sling device maintains many of the key elements that made GYNECARE® TVT the gold-standard in stress incontinence repair, adds the safety and convenience of the obturator approach, and further optimizes safety with a unique "inside-out" approach. The GYNECARE® TVT Obturator System "inside-out" technique passes the mesh device from a small incision in the vagina out to small incisions in the thigh folds. This passage away from the urethra and bladder avoids the retropubic space and therefore reduces the potential for urethral and bladder injury1 noted with other obturator devices using the "outside-in" technique.
How TVT Works:
Ordinarily, the urethra maintains a tight seal to prevent involuntary urine loss. For women with stress urinary incontinence, a weakened pelvic muscle floor cannot support the urethra in its correct position. To correct this, your surgeon will insert a ribbon-like strip of mesh tape through a small incision in the vagina and place it under the urethra. The tape provides unique support at the middle of the urethra (the section under the most strain during normal activities) whenever you stress this area, such as during a cough or a sneeze. This allows the urethra to remain closed, preventing involuntary urine loss. Placing the support in this area (as opposed to a position closer to the bladder, as in traditional sling procedures) helps maintain this part of the urethra in its proper position.
Recovery from the procedure takes 3 to 4 weeks. Heavy lifting and sexual intercourse should be avoided for 4 to 6 weeks. Normal daily activity can resume within 1 to 2 weeks.
Complications are rare and include bleeding; blood vessel, bladder, and bowel injury; and urinary retention. If painful urination (dysuria), bleeding, or other concerns arise, the patient should contact her physician immediately.
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