Sling/TVT-O for Incontinence
Indications or benefits: Treatment for stress urinary incontinence (leaking urine). Suburethral slings, also termed TVT, TVT-O, and TOT slings, are used to treat urinary incontinence. They are not new procedures but have become much more common in the USA over the last 5 yrs because they more effective and usually have fewer side effects and less recovery than most of the procedures done to treat urinary incontinence prior to the year 2000.
Most types have excellent data showing over 90% success rates, with few complications. Since most are made of permanent material, they should also last forever.
Risks: urinary retention (low), pain with sexual activity (low), bleeding (low), and damage to the bladder or urinary tract (very low)
Pre-procedure preparation: None, other than standard outpatient surgery preparation. Sometimes a patient may be asked to perform preoperative uro-dynamics testing
Procedure: All of the slings involve placement of a thin about 1/2 inch wide piece of material below the urethra, ie, just inside the opening to the vagina. Most look like a thin, loosely woven piece of flexible tape. The ends of the sling are passed through ligaments on the side of the pelvis using an introducer device; usually a hook. They are often performed under a "twilight " anesthesia; and when performed alone most patients go home right after the procedure. Some patients, usually less than 10%, go home with a catheter for one or two days. This is a decision your doctor will make.
Aftercare: After discharge office follow-up usually occurs in two to three weeks. During this time you may perform most normal daily activities including showering and driving.
We do ask that you avoid strenuous activities such as exercise or sexual activity in order that the sling may heal in the appropriate manner for 6 weeks.
Handouts and pamphlets will be available at your pre-operative visit that further describe your procedure. Several websites are also available, including www.PelvicHealthSolutions.com/SUI.