Tension-free vaginal tape (TVT) for stress incontinence

What is stress incontinence?

Stress incontinence is a condition where urine unintentionally leaks from your bladder, usually after pressure (stress) has been placed on it, such as during exercise, laughing, coughing or sneezing.

Weak pelvic floor muscles, which have been stretched or damaged during childbirth, can also play a factor in stress incontinence.

A weakness of the urinary sphincter, made worse by being overweight or by smoking, can also be a cause. Unless treated, the condition is likely to get worse with age.

After a procedure to insert a tension-free vaginal tape (TVT), urine should no longer leak from your bladder in an uncontrolled way.

What will happen during the procedure?

A TVT procedure is usually performed under a general anaesthetic and takes approximately 30 minutes to complete.

Your surgeon will make two small incisions on the lower part of your abdomen, above the pubic bone. A third small incision will be made in your vagina, just below your urethra.

Your surgeon will then pass a needle (called a tape introducer) through the tissues on each side of the urethra. The tape introducers are then pushed through the abdominal wall incisions on both sides so that a tape can support the urethra.

Recovery

You should be allowed to go home after you have passed urine in the normal way, usually later on the same day or the day after. Some women may need to use a catheter to assist them emptying their bladder immediately after the surgery, and some are given tablets or injections for pain relief.

Some women are able to return to work after three to four days, depending on the type of work. However, most need to wait two to four weeks before resuming their normal level of activity. Many insurance companies may insist you wait six weeks after the procedure before driving a vehicle.

Your consultant will likely tell you not to undertake any manual work for a while, such as heavy lifting. Sexual intercourse should be avoided for 4 weeks after the operation.

Continuing your pelvic-floor exercises can help prevent the incontinence from coming back and reduce the risk of a prolapse.