Tension Free Vaginal Tape Obturator (TVT-O)

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The TVT-O (Tension Free Vaginal Tape Obturator) is the newest and safest technique or surgical procedure for the treatment of Urinary Stress Incontinence. It is an innovative, minimally invasive procedure with more than 90% success rate in treating Stress Urinary Incontinence.

Many women around the world are affected with Urinary Incontinence. Coughing, sneezing, laughing, exercise or heavy lifting is often accompanied by involuntary leakage of urine (Urinary Stress Incontinence).

It is commonly associated with aging but can also affect women of all ages. However, it is important to know that these are common treatable conditions and you don’t have to live with it. There are many treatment options that can help you gain control over this condition. With proper medical care and treatment, you can regain your quality of life.

There are 2 methods of correcting urinary stress incontinence:

1) Non-surgical methods

  • bullet_tickVaginal Pessary. A therapeutic pessary is a medical device much like the outer ring of a diaphragm. Therapeutic pessaries are utilized to support the uterus, vagina, bladder, or rectum.
  • bullet_tickThe Kegel Exercise is safe but would have to take 6 months until results would show, and does not guarantee full recovery.
  • bullet_tickIncisionless Laser Correction. This new innovation has been recently introduced to Urogynecology and is now becoming a trend. This method is suitable for women with mild to moderate level of symptoms or for those with existing diseases that cannot be treated by TVT-O surgery.

2) Surgical methods

Urinary incontinence surgery is normally advised only when more conservative measures are not helping. Urinary incontinence surgery is a bit more invasive and carries a higher risk of complications compared to other treatments; however, it may also provide a long term solution in severe cases. Before you decide on urinary incontinence strategy, get an exact diagnosis. Several types of incontinence call for different surgical procedure.

  • bullet_tickUrethral Sphingter or Bladder Neck Injection by Filler to avoid the premature opening of the urethra.
  • bullet_tickBurch Colposuspension is the surgery of suturing the paravaginal tissues (near urethra) to periosteum of pubic bone.
  • bullet_tickA-P Vaginal Repair can temporarily treat the Stress urinary incontinence. You are likely to experience the symptoms again in 5 years after the surgery.
  • bullet_tickTVT-O (Tension Free Vaginal Tape Obturator) or Single Incision Sling (MiniArc Sling) is a minimally invasive procedure with an 85% – 90% success rate in treating Stress Urinary Incontinence.

 

normal bladder no urine leakage-TVT-O

 

Urethra is well supported, consequently without urine leakage.

 

normal bladder with urine leakage-TVT-O

 

Urethra is not supported, consequently urine leakage.

 

 

General Notes & Precautions

1) Important points to consider about TVT-O (Tension Free Vaginal Tape Obturator)

  • bullet_tickThis surgery has limitations and cannot absolutely ensure satisfactory results, because there are so many factors affecting the surgery’s success, especially for women with Mixed Urinary Incontinence (those with overactive bladder). She needs continuous medications after TVT-O (Tension Free Vaginal Tape Obturator).
  • bullet_tickAfter the surgery, some of you may experience increase in urinary frequency, slow urinary flow and/or longer time of urination (compared with that before the surgery).
  • bullet_tickIn case of unexpected surgical results or complications, corrective surgery is an option, and will be discussed between you and the surgeon. If the correction surgery wound occurs from a complication of the surgery, all expenses for services and treatment will no longer be charged to you. However, if the unsatisfactory results occur due to the complication from your non-compliance with the doctor’s orders, you will be charged accordingly.
  • bullet_tickThis surgery is not allowed for women with immunodeficiency, and you must not become pregnant, or plan to become pregnant in the future because of risk of Stress Urinary incontinence recurrence during pregnancy and postpartum. In addition, this surgery is not recommended unless you have a discussion with your spouse because this may lead to problems, and misunderstandings caused by refraining from sexual intercourse for quite a time.
  • bullet_tickThis surgery is performed in our operating room for approximately 1 hour under General Anesthesia administered by a board-certified anesthesiologist. You have to refrain from drinking water or food for at least 6 hours prior to the procedure in order to decrease the risk of aspirating gastric contents during or after surgery. This complication is very serious, and you need to strictly follow our recommendations.
  • bullet_tickThe most important preparations you should know before the surgery are that you should take a rest (refrain from work) and be still for 2-3 days after the surgery to enable the wound to heal faster, and have little movement as possible to avoid wound disruption for 1 week after the surgery. You should refrain from some types of exercise affecting pelvic muscle movement and sexual intercourse for at least 6 weeks after the surgery.

 2) Before the TVT-O (Tension Free Vaginal Tape Obturator)

  • bullet_tickPrior to the surgery, you will be invited to a pre-operative consultation room, where you will be evaluated for the surgery. You will be received by a member of the nursing staff in our Center, who will make inquiries regarding your previous medical history as well as arrange for your vital signs such as temperature, respiration, blood pressure, and pulse. In case of existing diseases or drug allergies, please inform the medical staff before the consultation. You should prepare and take with you any pills or treatment medications, you are currently taking.
  • bullet_tickYou can possibly have the surgery done on the day of your consultation depending on the availability of Dr. Vitasna’s schedule. Otherwise, you may book for a possible surgery on the day of your consultation. This you may do through online pre-consultation and arrangement. It is best to undergo the surgery after your period. It is not advisable to do the surgery just before the period starts or during the period.
  • bullet_tickA staff nurse will usher you to a treatment room, where Dr. Vitasna will investigate your health history, and conduct both a general check-up and internal check-up. In case you have vaginal fungal or bacterial infection, you should completely treat it before the surgery to avoid wound infection after the surgery.
  • bullet_tickAfter the examination and assessment, you will discuss with Dr. Vitasna about your expectations and concerns. She will then explain to you about the methods (or techniques), processes of the surgery, some potential post-operative risks and complications prior to decision-making. You may also be asked if you have any allergies or any condition that wouldn’t make you a good candidate for the surgery as well as other additional inquiries.
  • bullet_tickAfter you have chosen the best alternative for your case, prices and quotes will be written down with you. —This ends your consultation.

3) The cost of TVT-O (Tension Free Vaginal Tape Obturator)

  • bullet_tickThe cost of the surgery will include professional fees for the anesthesiologist and the surgeon, all the instruments, the home medications, and medicine used for the surgery as well. However, fees for laboratory workup for other existing diseases that you may have, and the professional fees for the anesthesiologist and the surgeon for corrective surgery are not included in the package.

The Pre & Post-operative Processes of the TVT-O (Tension Free Vaginal Tape Obturator)

1) On the appointment day you plan to have the Tension Free Vaginal Tape Obturator (TVT-O)

  • bullet_tickYou have to refrain from drinking water or food for at least 6 hours prior to the surgery. In addition, it is advisable to have a bath or perhaps a shower before you come into the hospital. You may need to bring along with you loosely fitting daytime clothing, personal hygiene stuff, loose fitting underwear, and sanitary pads.
  • bullet_tickBefore you go through the pre-operative processes, if you have more questions you will meet Dr. Vitasna for any additional information. In case of uncertainty, doubt and worry, or for being uncomfortable for any reason, you should postpone the surgical procedure.
  • bullet_tickIf you are a good candidate for the surgery, our medical staff will assess your vital signs, help you sign, and review the proper consent forms, which give us permission to perform the surgery on you. Then a staff nurse will review the post-operative care instructions, which you need to do after the surgery, and will guide you through the process of payment.–After that a member of staff will accompany you to the Inpatient Building.
  •  bullet_tickAs you arrive in the Inpatient Building, a staff nurse is going to check your information (name, birth date), show you your bed, assist you to change into a gown, and provide you with an identity wristband. She will assess your vital signs as well as arrange for some medical tests, i.e. blood tests, ECG, and probably a chest X- Ray.
  • bullet_tickYou will be directed to the anesthesiologist, who will administer the anesthesia during the surgery. Please tell him/her about your allergies to medications, your medical history, dental treatments, previous surgeries you have had, and any family history with anesthesia problems.
  • bullet_tickIf you are wearing nail polish or makeup, you may be asked to remove it. Contact lenses are to be removed as well as glasses and dentures. Jewelries are also to be taken out. Should you be unable to remove some piece of jewelry, a protective tape will be placed over it.
  • bullet_tickAfter all these have been done, a staff member will accompany you to the operating theater, and will hand you over the care of the anesthetic team. A staff nurse is going to check your information (name, birth date) and your vital signs. Once everything is complete and in order, a nurse will take you to one of the operating rooms.

The Tension Free Vaginal Tape Obturator (TVT-O) is one of the most complex and meticulous surgeries performed today. It requires extensive experience, precision, and accuracy to create the optimal results you desire and deserve. Many surgeons have little to no experience with this type of advanced cosmetic surgery. You should research and be conscious of the surgeon’s educational background, training, and practical experience.

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