TVT-O (Tension-free Vaginal Tape Obturator)

 

TVT-O is the newest and safest trend of surgical procedure for Urinary Incontinence. It is an innovative, minimally invasive procedure with an 85%- 90% success rate in treating Stress Urinary Incontinence.

It reconstructs and reinforces the ligaments and internal tissues to support the urethra and return it to its original position.

This procedure is called “Tension- Free” because the slings are not sutured into the muscle, fascia or bone. It is left alone for one’s own fibroblasts to grow and hold the mesh.

This procedure is performed in the Operating Room under General anesthesia/ Intravenous sedation by our board-certified anesthesiologist.

 

The Mesh

The TVT-O Device

TVT-O Placement

 

 

Single- Incision Sling (Mini- ARC)

 

Figure 1. Mini arc needle with mesh

Figure 1. Mini arc needle with mesh

 

Figure 2. Mini arc placement: supports the urethra, thus preventing urine leakage

Figure 2. Mini arc placement: supports the urethra, thus preventing urine leakage

 

  • MiniArc uses a slim 2.3mm needle and requires only a single 1.5cm vaginal incision. MiniArc utilizes American Medical System’s (AMS) proven Type 1 polypropylene mesh with a midline centering mark that promotes accurate placement under the urethra. AMS mesh facilitates healing and promotes tissue integration.
  • The MiniArc sling system allows the physician to place a small 8.5 cm piece of polypropylene mesh under the urethra. The sling cradles your urethra in a position that mimics normal anatomy to give it more support and prevent accidental urine leakage.
  • This procedure is performed in the Operating Room under General anesthesia/ Intravenous sedation by our Board-certified anesthesiologist.

 

 

Frequently Asked Questions for TVT-O:

 

What are the benefits of TVT-O?

  • It is safe and there have been no cases of polypropylene tape rejection to date.It is a simple, minimally invasive procedure.The tape can be adjusted during the procedure to achieve optimal position.Appropriate for older women and overweight womenShorter recovery time, fewer complications and less pain than current surgical treatments.

What are the risks and complications?

  • The risks and complications will be discussed with you in detail by the surgeon. The general risks of this procedure include, bleeding, wound infection, pain, scarring of tissues, failure of the procedure or potential injury to other surrounding structures.

Will there be pain after my surgery?

  • You should expect some mild pain after the procedure. Pain medications will be prescribed to control any discomfort. However, you have to report pain that can’t be controlled by pain medication.

Will I have difficulty urinating after the procedure?

  • Some patients experience temporary difficulty in emptying the bladder and may require a urinary catheter in the ward.

What is the risk of Urinary infection?

  • Although these events are usually infrequent, they can sometimes occur. Having infection is treated with antibiotics and adequate fluid intake.

When can I resume sexual intercourse?

  • You should refrain for sexual intercourse for a period of 4-6 weeks.

How long does the mesh remain there?

  • Evidence from long-term follow ups show that the mesh remains intact to support the urethra. Complications such as displacement or erosion of mesh must be reported to your gynecologist immediately.

What happens when the mesh fails?

  • As with any other surgical procedures, this operation has its limitations. If this procedure fails, you will need to be investigated with new urodynamic tests and treatment may be decided from the results. Corrective surgery is an option and will be discussed between you and the surgeon.