Inserting a Tension-Free Vaginal Tape

Stress incontinence is when urine leaks from your bladder. It usually happens when you do things that place pressure (stress) on your bladder such as exercising, laughing, coughing and sneezing.

Having weak pelvic-floor muscles is a common cause of stress incontinence. Sometimes stress incontinence can be caused or made worse by a weakness in the urinary sphincter (the valve that controls the flow of urine from your bladder).

Urine should no longer leak from your bladder in an uncontrolled way.

Are there any alternatives to inserting a Tension-Free Vaginal Tape?

Your doctor will usually recommend that you try simple treatments that are likely to improve your symptoms.

• Pelvic-floor exercises.
• Electrical stimulation.
• Incontinence devices.
• Bladder-neck bulking.

Having a transobturator tape (TOT) inserted is a similar operation to inserting a Tension-Free Vaginal Tape but the tape comes up out of your thigh crease instead of behind your pubic bone.

There are other surgical procedures such as Burch colposuspension and using your own tissue to create a sling (rather than using a synthetic tape).

The operation is usually performed under a general anaesthetic but various anaesthetic techniques are possible.

The operation usually takes about 30 minutes. Your doctor will make two small cuts on the lower part of your abdomen over your pubic bone. They will make another small cut on your vagina just below your urethra (tube that carries urine from your bladder).

They will pass a needle, with the tape, from one side of your urethra, behind your pubic bone, and up through one of the cuts made on your abdomen. Your doctor will pass the needle, with the tape, from the other side of your urethra, behind your pubic bone and up through the other cut on your abdomen.

You should be allowed home after you have passed urine in the normal way, usually later on the same day or the day after.

You may be able to return to work after 3 to 4 days, depending on your type of work. However, most women need to wait 2 to 4 weeks.

Do not lift anything heavy for a few weeks.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

Continue your pelvic-floor exercises as soon as possible and keep doing them for life.

Some of these can be serious and can even cause death.

General complications of any operation

• Pain
• Feeling or being sick
• Bleeding
• Developing a collection of blood (haematoma) behind your pubic bone
• Infection of the surgical site (wound)
• Unsightly scarring of your skin
• Blood clot in your leg
• Blood clot in your lung

Specific complications of this operation

• Damage to your bladder
• Damage to surrounding structures
• Urineinfection
• Overactive bladder
• Difficulty passing urine