Tension-Free Vaginal Tape System

Tension-free vaginal tape (TVT or TFT) procedure is a surgery procedure to correct involuntary leaking from the bladder (urinary stress incontinence) in women. A mesh tape is used as a sling underneath the area where the bladder and urethra connect. This restores the muscle and connective tissue (fascia) that have been stretched and damaged from having babies or from chronic stress and straining. The procedure takes less than 1 hour. You will go home the same day as the procedure (outpatient).

LET YOUR CAREGIVER KNOW ABOUT:

  • Any allergies, especially to medicines.

  • All the medicines you are taking, including prescription drugs, over-the-counter drugs, herbal medicines, eyedrops, and creams.

  • Previous problems with anesthesia or numbing medicine.

  • History of blood clots or other bleeding problems.

  • Previous surgery, especially bladder or vaginal surgery.

  • Other health problems or medical diseases.

  • Possibility of pregnancy, if this applies.

RISKS AND COMPLICATIONS

  • Bleeding.

  • Infection.

  • Injury to surrounding organs and blood vessels.

  • Problems with urination after the surgery.

  • Failure of the procedure to work as expected.

  • Allergy to the mesh tape.

  • Problems or allergies to the anesthetic.

BEFORE THE PROCEDURE

  • Do not eat or drink anything for 12 hours before the surgery.

  • Do not take aspirin or blood thinners (anticoagulants) for 1 week before the surgery.

  • Let your caregiver know if you develop a cold or an infection before the surgery.

PROCEDURE

An intravenous line (IV) will be placed in your arm. You will be given medicine to help you relax (sedative). You will be given medicine to numb the area above the pubic bone and along the top of the vagina (local anesthetic). Two very small cuts (incisions) will be made just above the pubic bone. The lining (mucosa) at the top of the vagina will be opened and separated on each side of the urethra and bladder. A thin, flexible tube (catheter) is then placed in the bladder for filling and drainage during the procedure. Then the mesh tape is placed under the urethra and the ends are passed up behind the pubic bone, just under the skin. After the mesh tape is properly placed, the catheter is removed. The patient is asked to cough so that adjustments can be made to the tape to make sure there is no leaking of urine before stitching (suturing) the mesh tape in place. The ends of the mesh tape are brought up, just under the skin, and sutured in place. The skin incisions are sutured closed. The vaginal lining is also sutured closed, and you are taken to the recovery room.

This procedure should not be done if the woman is pregnant or plans to get pregnant, is on anticoagulants, or has a urinary tract infection.

AFTER THE PROCEDURE

You will go to a recovery area until your vital signs (blood pressure, pulse, breathing, and temperature) are stable. You may need to stay in the hospital for 1 or 2 days, but most patients are sent home the day of the surgery. You may be sent home with pain pills or an antibiotic if necessary.

HOME CARE INSTRUCTIONS

  • Follow your caregiver's advice about diet, rest, driving, exercise, medicines, and follow-up appointments.

  • You may take over-the-counter pain medicine with your caregiver's recommendation.

  • Do not take aspirin. It can cause bleeding.

  • Do not lift more than 5 pounds (2.3 kg) until your caregiver says it is okay.

  • Do not have sexual intercourse until your caregiver says it is okay.

  • Do not use tampons.

  • You may take a laxative, if needed, with your caregiver's recommendation.

  • You may take sitz baths 2 to 3 times a day with your caregiver's advice.

SEEK MEDICAL CARE IF:

  • You have increasing pain in the wound area.

  • You have increased swelling and redness in the wound area.

  • You develop a rash.

  • You develop nausea, diarrhea, constipation, or vomiting.

  • You think the sutures in the wound are breaking up.

  • You lose urine when you cough or sneeze.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have a fever.

  • You begin to bleed from the wound area, above the pubic bone or vagina.

  • You see pus coming from the incisions.

  • You develop an abnormal vaginal discharge.

  • You cannot urinate.

  • You develop bloody or painful urination.

  • You pass out.

  • You develop chest or leg pain.

  • You develop abdominal pain.