Tension-free vaginal tape (TVT) - a new surgical procedure for female stress incontinence

A new, minimally invasive procedure for female stress incontinence has recently been developed in which a prolene tape is placed without tension under mid-urethra, usually using local anaesthesia and mild sedation. Post-operative catheterisation is not employed. Forty-two women with urodynamically verified severe urinary stress incontinence were operated on in 1996 and 1997. They underwent subjective and objective follow-up in 1998 with mean follow-up time 16 months, range 6-27 months. The procedure was well tolerated. All patients except four (90.2%) were discharged within 24 hours. Subjectively, 85.4% were cured and a further 9.8% had slight incontinence only and used no protection. Objectively, 80.5% were cured and 12.2% were >90% improved. There were no cases of long term voiding problems, recurrent urinary tract infections, de novo urge incontinence, or sling rejections. With medium term follow-up this procedure appears to have good results and few complications.