Abstract
Bladder neck and urethral closure with urinary diversion is offered as a last resort to patients with intractable urinary incontinence. Various techniques have been described to achieve bladder neck and urethral closure. Most of these are associated with either operative morbidity or long-term complications. A modification of the conventional tension-free vaginal tape (TVT) procedure is described. As the name suggests, during the conventional TVT procedure, the tape is inserted relatively without tension in such a manner that the urethra retains its function and post-operative voiding is possible. In the cases described in this short series, the aim was to achieve urethral and bladder neck closure with minimal operative morbidity. This was achieved by inserting the TVT exactly as in a conventional TVT procedure, but the tape was inserted under greater tension than is normally used to ensure continence. A long-term suprapubic catheter was used for urinary diversion. This procedure is simple to perform, is associated with low operative morbidity [Agostini et al., Eur J Obstet Gynecol Reprod Biol, 124(2):237–239, 2006] and results in functional urethral closure. Results suggest that it may be a useful alternative to other bladder neck and urethral closure procedures in selected patients.
Similar content being viewed by others
References
Agostini A, Bretelle F, Franchi F, Roger V, Cravello L, Blanc B (2006) Immediate complications of tension-free vaginal tape (TVT): results of a French survey. Eur J Obstet Gynecol Reprod Biol 124(2):237–239
Ward K, Hilton P (2002) Prospective multicentre randomised trial of tension-free vaginal tape and colposuspension as primary treatment for stress incontinence. BMJ 325:67–70
Ulmsten U, Henriksson L, Johnson P, Varhos G (1996) Ambulatory surgical procedure under local anaesthetic for the treatment of female urinary incontinence. Int Urogynecol J 7:81–86
Mundy AR, Nurse DE, Dick JA, Murray KH (1986) Complex urinary undiversion. Br J Urol 58(6):640–643
Feneley RC (1983) The management of female incontinence by suprapubic catheterisation with or without urethral closure. Br J Urol 55(2):203–207
Shaw PJR (1993) Supravesical bladder neck closure. In: Whitfield HN (ed) Rob and Smith’s operative surgery. Butterworth–Heinemann, Oxford, pp 283–287
O’Connor RC, Stapp EC, Donnellan SM, Hovey RM, Tse VW, Stone AR (2005) Long-term results of suprapubic bladder neck closure for treatment of the devastated outlet. Urology 66(2):311–315
Chancellor MB, Erhard MJ, Kiilholma PJ, Karasick S, Rivas DA (1994) Functional urethral closure with pubovaginal sling for destroyed female urethra after long-term urethral catheterisation. Urology 43(4):499–505
Boemers TM, Schimke CM (2005) Colpo-wrap: a new continence procedure. BJU Int 95(7):1063–1064
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Poddar, A., Jackson, S. Intentional urethral closure with a TVT (tension-free vaginal tape) for intractable urinary incontinence: a preliminary report of three cases. Int Urogynecol J 18, 195–197 (2007). https://doi.org/10.1007/s00192-006-0132-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00192-006-0132-8