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Urinary incontinence - tension-free vaginal tape

Contents of this page:

Alternative Names   

TVT; Urethral suspension

Definition    Return to top

Placement of tension-free vaginal tape is a procedure to help control stress incontinence, urine leakage that can happen when you laugh, cough, sneeze, lift things, or exercise. The procedure helps close your urethra (the tube that carries urine from the bladder to the outside) and the bladder neck (the part of the bladder that connects to the urethra).

See also:

Description    Return to top

You will have either general anesthesia or spinal anesthesia before the vaginal tape is put in place. In general anesthesia, you will be asleep and feel no pain. In spinal anesthesia, you will be awake but numb from the waist down, and you will not feel pain.

A catheter (tube) will be placed in your bladder to drain urine from your bladder.

A small incision (cut) is made in your vagina, just below the opening that urine passes through. Two small incisions (a little more than a 1/2 inch) are made in your belly just above your pubic hair line or in your groin.

A special synthetic (man-made) tape is passed through one of the cuts in your belly or groin. It is passed under your urethra, and then back up through the other cut in your belly or groin.

The doctor then adjusts the tension (tightness) of the tape so you will not leak anymore. If you do not receive general anesthesia, you may be asked to cough.

The surgery will take about 2 hours.

Why the Procedure is Performed    Return to top

Tension-free vaginal tape is placed to treat stress incontinence.

Most of the time, your doctor will try drugs and bladder retraining before talking about surgery with you.

Risks    Return to top

Risks for any surgery are:

Risks for this surgery are:

Before the Procedure    Return to top

Always tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.

During the days before the surgery:

On the day of the surgery:

After the Procedure    Return to top

You will be taken to a recovery room. The nurses will ask you to cough and take deep breaths to help clear your lungs. You will have a catheter in your bladder. This will be removed when you are able to empty your bladder on your own.

You may go home on the same day if there are no problems.

Outlook (Prognosis)    Return to top

Urinary leakage decreases for most women who have this procedure. But you may still have some leakage. This may be because other problems are causing your incontinence. Over time, some or all of the leakage may come back.

References    Return to top

Dmochowski R, Scarpero H, Starkman J. Tension free vaginal tape procedures. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, PA: Saunders; 2007:chap 68.

Update Date: 1/13/2009

Updated by: Louis S. Liou, MD, PhD, Assistant Professor of Urology, Department of Surgery, Boston University School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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