Urinary incontinence (involuntary leakage of urine) is an extremely common, distressing and socially disabling condition. It is known to affect up to 14 % of the adult female population in the United Kingdom. Sufferers tend to become social recluses, not wanting to socialise for fear of embarrassment and ridicule. It typically takes up to 5 years from the onset of symptoms for a patient to admit their problem, seek help and reach a specialist. Unfortunately, it is commonest in the elderly when the incidence is as high as 50% in some studies. Furthermore, this group of patients are the least likely to seek help, the least likely to receive help and up until recently the least likely to be cured of their problems.
GYNECARE TVT Obturator procedure starts at a precise mid-urethral point and continues away from critical structures utilizing an Atraumatic Winged Guide for accurate introduction and passage of the device, allowing for minimal dissection.
GYNECARE TVT Obturator procedure starts at a precise mid-urethral point and continues away from critical structures utilizing an Atraumatic Winged Guide for accurate introduction and passage of the device, allowing for minimal dissection.
Reported pain rates are low and there is no significant difference between the inside-out and outside-in approaches. GYNECARE TVT™ is a retropubic mid-urethral sling used for the treatment of female stress urinary incontinence. GYNECARE TVT Obturator System is a transobturator mid-urethral sling used for the treatment of female stress urinary incontinence.
A newer version of the continence procedure, TVT-O (tension-free vaginal tape-obturator) was introduced in January 2004. TVT-O continence surgery takes between 10 to 15 minutes to perform. It can be done under regional or general anaesthesia. It can be done as a day surgery so that the patient may go home on the same day. The post-operative pain and the risks of surgery are less as compared to Burch Colposuspension. As with any continence surgery, it is advisable for a patient who has not completed her family to do so before having the TVT/TVT-O surgery so as to reduce the risk of failure.
The TVT / TVT-O continence surgery is generally a safe procedure. However, like all surgeries, complications may occur occasionally. These include:
- Risk of anaesthesia
- Bleeding
- Infection
- Injury to surrounding tissues (e.g. bladder, rectum and blood vessels)
- Formation of blood clot in the legs or lungs
- Rejection of tape - As the tape is a synthetic tape which will be left permanently in the body, rejection may occur
As with other continence surgeries, there are certain bladder specific complications which may arise from TVT surgery:
- Injury to bladder for TVT; the risk is much lesser for the TVT-O surgery
- Need to go to the toilet frequently
- The urge to void
- Incontinence due to urgency
- Slow urine flow
- Inability to void completely necessitating prolonged catheterisation or intermittent self catheterisation
- Failure
Things are improving however, as everyone is more prepared to talk about this awful condition rather than accept it as a part of growing old. Furthermore, better treatments are becoming available which can help the old as well as the young.