Urethral sling/ Tension-free vaginal tape

The implantation of tension-free vaginal tape (TVT or transobturator tape- TOT) has proven successful for supporting the urethra in case of weakness in the pelvic floor. A small incision in the anterior wall of the vagina allows access to the urethra. The tape is placed around the urethra and passed out on both sides above the pubic bone or on the inner thighs. It is then cut off at skin level. The ligament should lie tension-free and fuse with the surrounding tissue. When standing up, the ligament provides support to the weight of the abdominal organs, which allows the transfer of pressure to the urethra.

During prostate cancer surgery, many men suffer a loosening of the surrounding support structures, which can result in incontinence. If mild to moderate incontinence is still present one year after the removal of prostate cancer, a sling operation can be performed. The insertion of tape is performed from the perineum, in a similar way as for women.

In addition to the general risks of any surgical procedure, such as bleeding, inflammation, and disruptions to wound healing, there are further risks unique to this procedure. Even though results are usually good and serious complication are very rare, incontinence can still persist. If the tape gets infected or is too tight, follow-up surgery will be necessary. It is rare for the tape to grow into the urethra. All possible risks of the surgical intervention are discussed in a detailed explanatory discussion with the patient before the procedure.

Admission for surgery takes place on the same day as the procedure. After the operation, inpatient treatment is recommended for one night, during which a bladder catheter is left in place. It is recommended not to lift any weights for 6 weeks to allow enough time for the band to grow properly into the surrounding tissue.