My Experience with TVT - Transvaginal Tape Surgery for Incontinence
When I was considering whether to get the tension free or trans- vaginal tape procedure for my incontinence, I was able to find lots of medical information online, but I found it difficult to find real life experiences from other women who had undergone this procedure. I wanted to learn all I could, but I wanted to go beyond scary stories about surgeries that had gone wrong. There was no way for me to know what side effects I would have, so I wanted to know realistically what to expect and what the normal experience is like.
My hope is that after reading this article, you will be better informed about the characteristics of tension free vaginal tape as you are trying to decide whether this procedure is right for you.
Diagnosis of Stress Incontinence
Transvaginal Tape is an out-patient surgery for stress incontinence. Stress incontinence is when you leak urine when stressing the bladder by coughing, sneezing, laughing, jumping, standing, running, and similar activities. Most doctors think that stress incontinence is due to the trauma of childbirth.
It doesn't take much to diagnose the condition since it is so evident, but there are a series of tests that can be done to rule out other conditions such as bladder infections, cysts, and anatomical issues.
The next step would be to try less invasive treatment options to see if they work for you. Kegel exercises are effective for many women, especially when their incontinence is not severe. Bladder training, diet and lifestyle changes can usually help these women to gain control of their bladder.
Unfortunately, these did not work for me, and my doctor and I decided that a TVT would be the best option. There are other surgical options that are available for this condition, but my doctor felt that the Tension Free Vaginal Tape would work best for me.
What is TVT - Tension-Free Vaginal Tape?
TransVaginal Tape is a mesh tape that is inserted under the urethra. It doesn't hold the bladder up; it simply sits underneath the urethra. When the urethra falls out of position when you stress it, the tape is there to keep it in its place.
One of the first questions people have with this procedure is about the mesh tape itself. There have been lots of television advertisements about a mesh that has been used for incontinence, and they are worried that the tape will cause similar issues. My doctor told me that the tape and the mesh are made with two different materials. I also found a YouTube video where a doctor explained the differences between the two.
Another concern is the effectiveness rate. Studies indicate that TVT work for about 80% of women. When playing the lottery, 80% seems like a very good chance, but it does mean that there is a 20% chance that you go through the risk and inconvenience of a surgery that will not work for you. I took comfort in the fact that I had a doctor that was experienced and caring. I was sure he had the skills and the personality to do his best to make sure that the surgery would be successful for me.
The tape is under the urethra and the ends are pulled up to the area right above the pubic bone. There are two small slits that are used, and since these slits don't even need stitches to secure, the scars are very small.
There are also the concerns about having any type of surgery. Any surgery has risks. Choosing a competent and experienced surgeon helps reduce some of the risk. There are many people who have surgery for cosmetic purposes, and it seems like having surgery for a medical condition that affects my life and my relationships with other people is worth it for me.
The cost of the surgery is another factor. My insurance company does cover it, and since it is an outpatient procedure, it is less expensive than one that would require overnight stays in the hospital. If the surgery is successful, there will be a cost savings since I wouldn't need pads and those types of supplies. To me, the value of being continent was worth the cost.
Preparing for TVT Surgery
There wasn't a lot to do to prepare for the surgery. I had an appointment with the surgery center of the hospital where they checked me to make sure that I was fit for surgery.
My doctor had warned me that the painkiller caused some people to be constipated, and that I should make sure that I was on a high fiber diet during the recovery. I bought some medicine for constipation as well as some fiber supplements.
In addition, I tried to do whatever I could to have a restful recovery period. I cleaned the house and prepared meals to put in the freezer so I would not have to cook. I also was not allowed to drive while I was on the pain medication, so I tried to anticipate and run as many errands as I could to avoid having to be driven everywhere.
I was not allowed to eat after midnight of the day before my surgery, which was not difficult at all since we had to be at the hospital at 5:30 for a 7:30 surgery.
TVT Surgery Day
On the day of the surgery, we went to the hospital, where I had another urine test and was told to get into my gown. The doctor and the anesthesiologist both came in to see me so I could ask any final questions about the TVT surgery and the anesthesia. Although some doctors prefer to do this surgery with a local anesthetic, so they can ask the patient to cough when it is over, my doctor preferred to do it with me unconscious. I prefer that as well.
I was wheeled into the operating room, given the anesthesia. According to what I have read, the surgery itself takes about half an hour. When I woke up, I was in the recovery room. The nurse told me that my bladder had been nicked and that I would be using a catheter for a week as a precaution against infections. I received a snack - coffee and graham crackers, and discharge instructions and was sent home. I was expected to be discharged at 10:30, but it took slightly longer because I threw up the coffee and graham crackers.
When I got home, I slept and read the rest of the day.
Recovery from TVT Surgery
Since it is outpatient surgery, recovery from TVT surgery is pretty quick. Most people can go back to work in two weeks, and people with physical labor jobs can go back to work in 6 weeks. I was encouraged to try to resume daily activity the next day, but to listen to my body and to not overdo things. This meant that while I couldn't cook a three course meal for a party, I could cook up quick things for myself.
Two weeks seems fair to me. Even though I wasn't at 100% in two weeks, I felt well enough to go back to work. In fact, during those two weeks, I continued to write articles for this site, since I could work at my own pace.
During the recovery period, and probably for two or three more months to be safe, you should avoid stressing your bladder by lifting heavy things. I was told not to lift anything heavier than 20 pounds. Also, since most of the work is done through the vagina, there are stitches that need to be healed. Because of this, the doctors recommend you hold off having sex while you are healing.
One thing I hadn't expected was pain. There are times I can feel the tape and have to reposition my body so that the tape is in a more comfortable position.
Issues With TVT Surgery
I did have some issues with the surgery that I was not expecting, and think it is important for women to know about the possibility.
Even though stitches aren't needed outside the body, the two little slits that were cut on the outside of the body still need to seal up. I felt some pulling in the area as the skin stretched from other areas to close up the wounds. This pulling worried me, because I was afraid that there was something wrong with my stitches, but I was healing quite normally.
The other issue is that, at times, I can feel the tape, and feel it pinching my body. It happens at various times, like when I am voiding my bladder, sleeping on my side, and sometimes simply sitting or standing. Generally, adjusting my body position takes away the pain. I am hoping that as the scar tissue forms and my body gets used to the tape, this issue will go away.
Follow-up Visits with Doctor
You should make sure that you see your doctor within the first two weeks of your surgery. If there is a problem with the surgery, it needs to be corrected right away. After two weeks, scar tissue will be forming, making it difficult to take out the tape. If a problem is detected after the scar tissue has been formed, the tape is cut, thereby loosening any tightness, but remains in the body.
Your doctor will want to continue to monitor you to make sure that you are completely dry. The definition of success is for you to not have to wear a pad anymore. This, I think, is good news. Even though the success rate is 80%, it is quite possible that the remaining 20% saw improvement, but not sufficient enough to call the surgery successful. If you are not completely dry, then it is quite possible that you also have some urge incontinence, or have trouble completely emptying the bladder. In this case, those conditions would need to be treated as well.
My doctor did recommend that I continue the Kegel exercises for life.
© 2013 Shasta Matova