Tension-free vaginal tape (TVT) found efficient for treating urinary incontinence

A new minimally invasive alternative found for surgical correction.

The TVT device, showing the polypropylene tape with the cover in place, the trocars and introducer handle
The TVT device, showing the polypropylene tape with the cover in place, the trocars and introducer handle.

A study at BJU International indicates that tension-free vaginal tape (TVT) may be a highly effective and safe option for certain patients with urinary incontinence.

Several new surgical procedures have recently been evolved for treating urinary incontinence, using a variety of sling types. In TVT surgery, a mesh tape is placed under the urethra to keep it in its normal position, so that when a person coughs or moves suddenly, the urethra can remain closed with no accidental release of urine.

Different studies comprised a mixed population of primary and secondary stress incontinence. Treatment outcomes of TVT in women as a primary procedure appear marginally better than in patients in whom previous surgery has failed.

The TVT offers women with uncomplicated stress incontinence a minimally invasive alternative for surgical correction. Perioperative risks are low, hospitalization short and the return to work/activity rapid.

The success rate of TVT in patients with a low-pressure urethra is lower in some series.

There are various reports on the use of TVT in treating mixed stress and urge incontinence in which 25–60% of these patients report resolution of their urgency after the procedure. The remainder reported their urgency as being improved or unchanged, with a few being worse. In most cases, the stress component is cured.

For instance, at 17 years after surgery, 41 of 46 women (89.1%) who underwent TVT implantation declared themselves cured. Similarly, 42 of the 46 women (91.4%) were objectively cured, as determined by clinical tests.

Early published data suggest good success rates, with a minimally invasive procedure that can be performed under local anaesthesia with low morbidity. The procedure has gained widespread popularity amongst both urologists and urogynecologists, although long-term results are not yet available.