Urethral Suspension—Tension-Free Vaginal Tape Procedure
DefinitionStress incontinence is one of the many causes of uncontrolled leaking of urine. Urethral suspension is a surgery to correct incontinence in women. The incontinence is most often caused by weakening of the pelvic muscles that normally keep the bladder in position. The muscles may be weakened by:
|Female Bladder and Urethra|
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Reasons for ProcedureThe goal of this surgery is to provide extra support to the urethra and give more resistance against leakage. This will stop the uncontrolled leaking of urine.
Possible ComplicationsComplications are rare, but no procedure is completely free of risk. If you are planning to have a urethral suspension, your doctor will review a list of possible complications which may include:
- Reactions to anesthesia
- Inability to urinate
- Continued incontinence or recurrence of the problem
- Damage to other nearby organs or blood vessels
- Erosion of the mesh material used during the procedure
- Pain, such as during sexual intercourse
- Chronic disease such as diabetes or obesity
What to Expect
Prior to ProcedureYour doctor will try to find out why you are leaking urine through some or all of the following:
- Medical history—information about medications, illnesses, number of pregnancies, and previous surgeries; pattern of leaking and how it is affecting your life
- Urine sample—to look for the presence of infection or other problems
- Physical exam—includes a rectal and vaginal exam
- Additional testing may be ordered to evaluate bladder function and urine flow, such as:
- Urodynamic testing (urine flow studies)—a temporary catheter is placed to study bladder function
- Cystoscopy —a procedure done to view the inside of the bladder
- Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
- Arrange for a ride home from the hospital.
- Do not eat or drink anything after midnight the night before.
AnesthesiaYou may receive a spinal anesthetic to numb your lower body. General anesthesia may also be used, in which case you will be asleep.
Description of ProcedureTwo incisions will be made in the vagina. A nylon, mesh-like tape will be inserted in these incisions to form a hammock. This will give support to the urethra, closing the urethra during a cough or sneeze. No sutures will be needed to hold the tape in place. The mesh will hold onto the surrounding tissue until scar tissue grows into it.
Immediately After ProcedureAfter surgery, you will be monitored in a recovery room. You will most likely have a catheter in place to drain your urine.
How Long Will It Take?1-1.5 hours
How Much Will It Hurt?Anesthesia will block pain during the surgery. After surgery, you may experience some pain or soreness. You will be given pain medicine to relieve discomfort.
Average Hospital StayYou may be able to go home the same day.
Postoperative CareAt the HospitalAt first, your urine may look bloody. This will resolve over time. When you are able to empty your bladder completely, the catheter will be removed. You may be up and walking the same day as the surgery.During your stay, the hospital staff will take steps to reduce your chance of infection such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
- Washing your hands often and reminding visitors and healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
- Not allowing others to touch your incisions