Sling Urethropexy or Tension-Free Vaginal Tape Procedure

A treatment for stress incontinence.

Tension-Free Vaginal Tape Procedure:

A sub-urethral sling is inserted under the urethra supporting the urethra to correct urinary stress incontinence.

A mesh-like tape is surgically inserted through the vagina to support the urethra. It is inserted through a small incision in the vagina and brought out through two small incisions above the pubic bone.

Urinary Incontinence

Urinary Incontinence results with dysfunction of one of the normal bladder control mechanisms is impaired through disease, trauma or the natural aging process.

For proper bladder control the following must work in conjunction:

  • The pelvic muscles must hold up the urethra and bladder
  • The urethra must be open and shut by the sphincter muscles
  • The bladder and pelvic floor muscles must be controlled by the nerves

Stress Incontinence:

Stress incontinence is the most common type of leakage encountered. Stress incontinence is the loss of urine that occurs with any maneuver that increases intra-abdominal pressure, such as

  • coughing
  • sneezing
  • lifting
  • laughing
  • intercourse
  • changing position

This typically occurs in women that experience loss of support in the anterior vaginal wall leading to dropping of the bladder neck and urethra during increases in abdominal pressure. Most investigators feel that the descent of the bladder neck and urethra out of the normal intra-abdominal position into the pelvis prevents closure of these structures during times when pressure is exerted on the bladder body. Some feel that the change in the angle of the bladder neck and urethra are responsible for the leakage. Stress incontinence can occur in men as well, but is most often seen following trans-urethral prostate surgery or surgery for prostate cancer.

Cause of acute or temporary incontinence:

  • Childbirth
  • Limited mobility
  • Medication side effect
  • Urinary tract infection
  • Constipation

Causes of chronic or longstanding incontinence:

  • Birth defects
  • Bladder muscle weakness
  • Blocked urethra (due to benign prostate hyperplasia, tumor, etc.)
  • Brain or spinal cord injury
  • Nerve disorders
  • Pelvic floor muscle weakness

Vancouver Island Health Authority. 2010. Sling Urethroplexy Monarc/SPARC/TVT.

North Shore Health Region: Lions Gate Hospital.

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