After the Tension Free Vaginal Tape Obturator (TVT-O)

1) The Processes of after the TVT-O (Tension Free Vaginal Tape Obturator)

• After the TVT-O surgery, you are assured to be well taken care of in a safe and professional way by our highly trained and educated staff. You will be monitored at the recovery room for 1-2 hours. When you are conscious with normal vital signs, the anesthesiologist will allow you to be monitored in the Inpatient Building. Nausea and vomiting may be experienced, as a side effect of the General Anesthesia, which is noted to be relieved as soon as its effect wears off.
• In the Inpatient Building you may experience pains around the surgical wounds on both sides of the thighs, and the surgical wound inside of the vagina, so you should take an acetaminophen, an anti-inflammatory, a laxative, and an antibiotic, as prescribed by Dr. Vitasna.

2) The symptoms and processes after the TVT-O (Tension Free Vaginal Tape Obturator)

• Pain levels depend on an individual’s pain tolerance. Pain varies from person to person. If the pain cannot be relieved from the acetaminophen, the nurse will administer an analgesic by injection as ordered by Dr. Vitasna.
• Within 24 hours after the surgery, the urinary catheter will be removed. Dr. Vitasna will remove the Vaginal packing from the vagina and the gauze pack from both sides of the thighs, and she will clean the surgical wounds on both sides of the thighs with antiseptic. The surgical wounds will then be covered with the Tegaderm ® to prevent moisture around the surgical wound, which may potentially cause infection. 

Dr. Vitasna will allow you to return home after the following things are checked…

1. No abnormal bleeding occurs from the surgical wounds.
2. You are provided instructions regarding post operative care.
3. You can pass urine by yourself after the urinary catheter is removed.

3) Post Operative Care Instructions at home after the TVT-O (Tension Free Vaginal Tape Obturator)

• At home, you must take an antibiotic, an anti-inflammatory drug, a laxative drug, and an acetaminophen. The antibiotic should be completely consumed according to schedule.
• After 1-2 day of the surgery, you are allowed to take a shower, you should clean the perineum area with soap daily, when you are taking a shower in the morning or before bedtime. Do not put anything to clean inside of the vagina.
• Within the first 2-3 days after the surgery, you should take a rest (refrain from work) and be still to enable the wound to heal faster, and have little movement as possible to avoid wound disruption. 
• You may experience light reddish bleeding out of the vagina in around 1-2 weeks after the surgery. A slim sanitary napkin should be used to monitor the post-operative bleeding. In case of a lot of bleeding or blood clot, swollen reddish wound and high fever, please contact the Hospital for suggestions or come to see Dr. Vitasna for the surgical wound examination.
• Within the first 2 weeks after the surgery, cleaning the perineum after urinary excretion may be done with sanitary wipes, and after fecal excretion done using water and toweling gently. You should try to avoid moisture around the surgical wound to keep the area dry to let it heal faster.

4) Things you should know after the TVT-O (Tension Free Vaginal Tape Obturator)

• You may experience light reddish bleeding out of the vagina in around 1-2 weeks after the surgery. A slim sanitary napkin should be used to monitor the post-operative bleeding. In case of a lot of bleeding or blood clot, swollen reddish wound and high fever, please contact the Hospital for suggestions or come to see Dr. Vitasna for the surgical wound examination.
• After the surgery, you may have all kinds of food, with the exceptions of alcoholic drinks, pickled food, and smoking for about 2 weeks.
• The material used for the surgery is the suture which dissolves slowly (within 4-6 weeks). However, for some women, the suture takes longer than 6 weeks to completely dissolve, consequently this may cause irritation. For women who experience itching caused by the dissolving sutures and the process of healing, Dr. Vitasna may prescribe antihistamine to control the itching.
• You may have abnormal vaginal discharge, a green-yellowish discharge after the surgery, because the vagina is full of secretion fluid and various kinds of bacteria. This can cause reaction to the surgical wound and sutures. Complete absorption of the sutures will usually occur within 6-8 weeks. Green-yellowish discharge may also persist during this time.
• You may have itching or curd like discharge as a result of vaginal fungal infection, possibly following taking antibiotic to avoid post-operative infection. In case of smelly vaginal discharge or vaginal fungal infection, you have to take additional medications.

5) Recovery period after the TVT-O (Tension Free Vaginal Tape Obturator)

• Recovery varies with each woman. You may return to work after 2-3 days of the surgery. Dr. Vitasna will have a post-operative appointment with you in 1 week after the surgery, she will check the surgical wounds, and you may need to be removed the Tegaderm ® from your thighs. You should follow Dr. Vitasna’s appointment for follow up examination or treatment.
• Within the first 2 weeks after the surgery, tissues are beginning to produce and form new blood capillaries, and the surgical wound are expected to start healing. You may start your daily activities gradually.
• After the first 2 weeks to 4 weeks after the surgery, the surgical wound is expected to heal appropriately, you may start your usual activities gradually. Strenuous physical activities should be limited.
• After 4 weeks of the surgery, relaxing exercises and lifting light weights are permitted. However, you should refrain from running, soaking in the bathtub, swimming, heavy lifting, cycling, other heavy activities, and sexual intercourse for at least 6-8 weeks after the surgery.

If you decide to have a consultation with Dr. Vitasna, please call or e-mail a member of staff to make an appointment date for the surgery.

At long-term follow up, TVT-O (Tension Free Vaginal Tape Obturator)  is highly effective and safe for the treatment of stress urinary incontinence. The rate of post-surgical complications is low, especially when it is done by an experienced surgeon, and you carefully and religiously follow our post-operative policies. In the unlikely event of a post-op complication, you should immediately see Dr. Vitasna for early examination, and treatment, and prevent worsening of the complication.