If you are like Gale, and thousands of other women, you may suffer daily and needlessly from stress incontinence. Stress incontinence is the involuntary loss of urine during exercise. The loss of urine can also happen during simple, but important, routine acts such as laughing, coughing, sneezing or lifting. The reasons are varied and can include aging, menopause, multiple pregnancies, large babies or vaginal childbirth. Regardless of why you are afflicted with this embarrassing condition, with the accompanying discomfort, Stress incontinence becomes a problem when there is damage to the muscles and nerves of the pelvic floor. The muscles that support the urethra are weakened and are no longer able to effectively support the area, leading to involuntary urine leakage. This is not to be confused with urge incontinence which is the feeling of not being able to get to the bathroom, in time, when you need to void. That is a separate condition and will not be fixed by TVT surgery.
TVT surgery is a simple surgical procedure that can make a surprising change for the better to your life. TVT stands for Tension Free Vaginal Tape (TVT). It can bring “dryness” back to your life and restore your feelings of well being, dignity and self esteem while allowing you to resume activities that were lost due to incontinence.
Your family physician can discuss this option with you. He /she will refer you to a gynecologist who specializes in performing TVT surgery. From there, it becomes a matter of deeming that you are a suitable candidate. You may be asked to record a 24 hour “voiding diary” prior to your appointment as well as recording the amount and time of voiding in a 24 hour period. You will undergo urodynamic testing in the specialist’s office which involves placing a catheter into your bladder and then filling it with fluid, under pressure, to again determine if you are a suitable candidate for a successful surgical intervention.
If you are deemed suitable your OR date will be set. You will receive pre-op instructions and may require some blood work and an ECG test prior to your surgery date. A word of caution to those that like to research; Gale watched a detailed internet video on TVT surgery prior to her operation and after watching she considered cancelling her OR date and walking away from the procedure. Please remember that all surgeries do not look nice on video, especially when you think in terms of your own body undergoing the operation. Your surgeon, anaesthetist and OR nurses will ensure your comfort prior, during and after your operation.
The day of the surgery you will receive an I.V for fluid and drug administration. You will meet your anaesthetist who will outline the kinds of anaesthetic you can receive during your surgery. Gale chose a general anaesthetic. Once she was placed in the operating room she was covered in a warm blanket and awoke approximately 45 minutes later in the recovery room with a catheter in place.
During the TVT surgery, which takes approximately half an hour, your surgeon will make a small incision in your vagina. A mesh like hammock is inserted through the incision and pulled through the outside of your body in the bottom area of the pubic hair. It is then clipped off at the surface, thus suspending the urethra in such a way that stress incontinence becomes a thing of the past.
Following your time in the recovery room, a nurse will remove your catheter and ask you to void in the toilet. She will then scan your bladder with a small ultrasound machine to record the amount of any residual urine. You must be able to empty your bladder before discharge. Gale had no problems in this area and was discharged within a few hours with minimal discomfort. Following her surgery she required only regular doses of tylenol and ibuprophen for the first few days to control the small bit of pressure and fullness she felt in her pubic area.
Post surgery, you will have instructions not to lift over 10 pounds, no heavy housework, no vacuuming or grocery carrying (how awesome is that!) and no sexual intercourse for a period of 4 weeks to allow scar tissue to grow which will secure your new hammock into place. The period of time that you will be off work will depend on the type of job you have. Walking is encouraged as an excellent activity. Showering is allowed the next day.
A follow up appointment will be booked to ensure healing has taken place.
Drawing from Gale’s personal experience she would recommend this surgery to anyone who finds that stress incontinence is hindering their ability to enjoy a normal life. It had been such a long time since the birth of her last child that she forgot what “normal” was like. The results were immediate for her. She is now at the 5 week mark and can laugh with confidence and she’s looking forward to introducing varied exercises into her daily life without fear of incontinence.
