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Tension-free vaginal tape

BMJ Group Medical Reference

Introduction

This information is for people who have stress incontinence. It tells you about tension-free vaginal tape, a treatment used for stress incontinence. It is based on the best and most up-to-date research.

Does it work?

Yes. Tension-free vaginal tape seems to work for most women. You'll need an operation to put in vaginal tape. But there is a very small risk of serious complications from this type of surgery.

Vaginal tape works as well as a bigger operation called colposuspension.

What is it?

Tension-free vaginal tape (TVT) is a newer type of sling. The main difference between vaginal tape and traditional slings is that you don't need a large cut in the abdomen to have vaginal tape put in.

The operation to put in vaginal tape takes about 30 minutes. The tape is made from a man-made material, such as polypropylene (Prolene).

The first part of the operation is done through your vagina. A surgeon places the tape under the middle part of your urethra (the tube that carries urine from your bladder). The tape is then pulled through two tiny cuts on the surface of your abdomen, just above your pubic area. But doctors do not pull the tape tight, as they do with other types of sling. That's why it's called tension-free. Your body makes scar tissue that grows into the tape and keeps it in place. This gives extra support for your urethra.

The National Institute for Health and Clinical Excellence (NICE), the government body that advises doctors about which treatments should be available on the NHS, has approved the use of vaginal tape. [61] But you can only choose this treatment if: [76]

Vaginal tape seems to work well, but we don't know yet if it's safe in the long term.

You'll probably be given a local anaesthetic or epidural for this operation. This means you won't be asleep, but you won't feel any pain.

Vaginal tape has some advantages over other types of surgery for stress incontinence.

  • The operation takes about 30 minutes, compared with about an hour for most types of surgery.

  • You get back to normal much more quickly. You'll need about two weeks to recover from vaginal tape surgery. For standard surgery, recovery can take two months.

  • You're less likely to need strong painkillers. Only about 1 in 5 women who have a vaginal tape operation need strong painkillers called opiates. For other kinds of surgery, nearly everyone needs these painkillers afterwards.

  • You'll be able to leave hospital sooner (usually within a few days).

As in other operations for incontinence, you'll need a tube (called a catheter) to empty your bladder straight after the operation. The tube will be removed as soon as you can empty your bladder yourself.

Your doctor may suggest a newer operation using vaginal tape, which is slightly different from the one we describe here. For more details, go to Transobturator tape (TOT).

Last Updated: October 11, 2012
This information does not replace medical advice.  If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.

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