Urethral slings/tapes

To support the urethra in the case of pelvic floor weakness, the implantation of a tension-free tape has proven effective ("tension-free vaginal tape" – TVT or "transobturator tape" – TOT). Access to the urethra is created via a small incision in the anterior vaginal wall. The tape is placed around the urethra and led out on both sides above the pubic bone or on the inner thighs. It is then cut off at skin level. The tape should lie tension-free and grow into the surrounding tissue. When standing up, the tape acts as a counterbearing to the weight of the abdominal organs, which enables good pressure transmission to the urethra.

Apparently, in many men, prostate cancer surgery does not directly injure the sphincter, but only loosens the surrounding supporting structures, which can result in incontinence. If mild to moderate incontinence still persists one year after prostate cancer removal, sling surgery can also be performed in men. In a similar way to women, the tape is inserted via the perineum.

In addition to the general risks of any operation, such as bleeding, inflammation and impaired wound healing, there are other special risks with this operation. Even though the results are usually good and serious complications are very rare, the incontinence may nevertheless persist. If the tape becomes infected or is too tight, follow-up operations must be carried out. Ingrowth of the tape into the urethra is rare. All possible risks of the surgical procedure are discussed in a detailed consultation before the operation.

Patients are admitted on the day of the operation. After the operation, inpatient treatment for 1 night is recommended, during which time a bladder catheter is left in place. It is advisable not to lift any loads for 6 weeks to give the tape enough time to grow correctly into the surrounding tissue.