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Tension Free Transvaginal Tape (TVT Sling)
What is Tension-Free Transvaginal Tape (TVT Sling)?
Tension free transvaginal tape (TVT sling) was first introduced in Sweden in the mid 1990's by Ulf Ulmsten and Papa Petros. The TVT sling is a technical advancement of a traditional operation known as a suburethral, pubourethral or pubovaginal sling. The literature supports the pubovaginal sling operation as one of the two most effective operations for the treatment of stress urine incontinence. The other most effective known operation noted in the literature is the Burch urethropexy. The TVT sling device is intended to be used as a pubourethral sling for treatment of female stress urinary incontinence (SUI) resulting from urethral hypermobility and/or intrinsic sphincter deficiency. So why is it considered a surgical advancement over traditional pubovaginal slings?
Fig. 1
The TVT sling's main advantage is that a sling is placed, providing new support to failed native tissue, with less morbidity than traditional sling procedures. There is no need to harvest graft material. In other words, create another incisions to take a graft from another part of the body. Therefore... less incisions and needless to say less pain. Additionally, intraoperative assessment is possible via a cough test, as the procedure is performed under local, spinal or epidural anesthesia. The patient is actually asked to cough with a full bladder at the very end of the operation and when leakage occurs the TVT sling is gently adjusted to correct the leakage.
The TVT Sling is a Designer Sling
...a sling procedure that is adjusted for your individual needs. Most slings are indiscriminately pulled "tight" which may indeed correct the leakage…but may also cause the patient great difficulty with urination after the operation. This adjustment is individualized for each patient during the TVT sling operation thus dramatically reducing the chance the patient will need a catheter for any prolonged time period after the operation.