Tension-free vaginal tape is a man-made tape used in the treatment of stress incontinence in women. Stress incontinence is a condition in which a woman releases urine without meaning to because of an activity or event that stresses the bladder. For example, a woman with stress incontinence may accidentally urinate when she sneezes, coughs, or laughs. Sudden movements and vigorous exercise may cause involuntary urination as well. Tension-free vaginal tape is placed in a woman’s body to support the urethra, which is the opening through which urine is expelled, and prevent stress incontinence.
Made of a type of mesh, tension-free vaginal tape is inserted into the body surgically. This tape is used to form a sling–like structure under a woman's urethra, which ensures it will stay closed when subjected to the stress of coughing and similar acts. It stays in the woman’s body once the surgeon is satisfied with its placement.
Women who opt to use tension-free vaginal tape to treat incontinence may undergo surgery with either local or general anesthesia. Both types of anesthesia ensure that a woman won’t feel pain during her surgery. General anesthesia puts the patient to sleep while local anesthesia allows her to remain awake and alert during the procedure. While the type of anesthesia used may depend on the preferences of the patient and her doctor, there is a major benefit to receiving local anesthesia for this procedure. If a patient remains awake, her doctor can ask her to cough during the procedure and check to make sure the tape is performing as it should before closing her incisions.
To place tension-free vaginal tape in a woman’s body, a surgeon makes three incisions. He makes one incision just below the urethra and two above the patient’s pubic bone. The doctor then guides the tape in through one of the incisions above the pubic bone, beneath the patient’s urethra, and out of the second incision that is above the pubic bone. The surgeon then makes sure the tape is tight enough to prevent the urethra from leaking urine.
To ensure that the bladder doesn’t have any perforations in it and check the effectiveness of the tape, a surgeon usually fills the patient’s bladder with a saline solution and checks for leaks. If the patient is awake, he asks her to cough and notes whether the urethra allows the saline solution to leak from the bladder. Once he’s satisfied with the tape's placement and tightness, he closes the patient’s incisions.
Most people recover from this surgery without complications, but infection, retention of urine, bladder perforation, and reactions to anesthesia are among the risks patients face with this surgery. Patients are typically released from the hospital on the same day or spend one night in the hospital. They are usually able to return to most activities about two weeks after the surgery, but are advised to wait six weeks before having sex or participating in strenuous exercise.