Trans vaginal tape
readjustment after unsuccessful tension-free vaginal tape operation.
Menahem Neuman Urogynecology, Department of Gynecology,
Shaare Zedek Medical Center, Jerusalem, Ben-Gurion University of the
Negev and Urogynecology Service, American Medical Center, Rishon
This study is aimed at evaluating a new surgical technique
to deal with tension-free vaginal tape (TVT) failure. The TVT
operation, described by Ulmsten in 1995, is based on a mid urethral
Prolene tape support. TVT is accepted as an easy-to-learn and safe
minimal invasive surgical technique. Yet, as with other surgical
methods for correction of female urinary stress incontinence,
therapeutic failures occur with TVT also.
Described here is a new approach for addressing this
issue. Out of 344 women who underwent TVT and who were followed for
up to 55 months, four (1.2%) requested to be reoperated on the
grounds of a diagnosis of operative failure. These four women were
treated by trans vaginal readjustment of the tape.
out of the four reoperated patients reported subjective continence,
subsequently confirmed clinically. The fourth patient, although
suffering residual minor urinary leakage, declined further
The readjustment technique seems effective, easy, and safe for the
treatment of failed TVT operations. More experience is needed prior
to suggesting this technique as a recommended approach. Neurourol.
Urodynam. 23:282-283, 2004.
Neurourol Urodyn. 2004 ;23 (3):282-3