TVT stands for Tension-free Vaginal Tape which is made of prolene. It has become the new "gold standard" operation for treating women with stress urinary incontinence. The result at 5 years is 85% cure, 10% improved and 5% failure. It was introduced in Sweden in 1995. The first operation in Singapore was performed at our hospital in November 1998. A newer version of the procedure, TVT-O (tension-free vaginal tape-obturator) was introduced in May 2004 in our hospital. It is equally good in curing stress urinary incontinence.
Both the TVT & TVT-O continence surgery takes between 10 to 15 minutes to perform. It can be done under regional or general anaesthesia. It can be done as a day surgery so that you may go home on the same day. The post-operative pain and the risks of surgery are less as compared to Burch Colposuspension - another well-established continence surgery. As with any continence surgery, it is advisable for a patient who has not completed her family to do so before having the TVT/TVT-O surgery so as to reduce the risk of failure.
The TVT / TVT-O continence surgery is generally a safe procedure. However, like all surgeries, complications may occur occasionally. These include:
As with other continence surgeries, there are certain bladder specific complications which may arise from TVT surgery:
The TVT / TVT-O continence surgery is usually done under regional or general anaesthesia (i.e. where you will be asleep throughout the operation). You may discuss it with the anaesthetist.
The TVT operation involves two small incisions of 0.5 cm each on your lower abdomen below your pubic hairline and a 1.5 cm incision on your anterior vaginal skin. The TVT tape is inserted below your urethra into the abdominal wound. The operation takes about 15 minutes. At the end of the surgery, a urinary catheter may be inserted into your bladder to allow free urine flow. A vaginal pack may be inserted as well.
The TVT-O tape is inserted through the same 1.5 cm anterior vaginal wall incision; but has two 0.5 cm incisions in the groin area instead.
After the surgery, you will be seen at 1 week, 1 month, 6 months and yearly intervals thereafter. Urodynamic studies will be repeated at 6 months after surgery to confirm cure and to exclude other bladder disorders.
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