|TVT (tension free vaginal tape) is a kind of sling that uses a prolene tape
placed in mid region distal of the urethra, applied with no tension and without the need
of a suture or fixation. It is an easy procedure, which can be done as an out patient with
local anesthesia, if the surgeon and the patient prefer. This surgery is useful for
elderly women, obese, patients with previous surgical interventions and is indicated in
carriers of SUI by urethral hypermobility and/ or intrinsic sphincterian deficiency.
This technique was developed in Sweden by Ulmsten et all. Whose objective was to establish functionally the pubo urethral ligament, and is based on the "integral continence theory", developed by Petros and Ulmsten, described in 1990. these authors understand the adequate function of the pubo urethral ligament, the mechanism of urethral sustentation and the good functioning of the pelvic floor muscles, are responsible for maintaining urinary continence.
The published results with this technique show cure indexes of around 85% - 90% in short and middle term. Nowadays, the sling placement is the most common surgical treatment of SUI, but at the same time it is the most frequent cause of complications caused by obstructive processes. It is never to much in insisting that you should not compress the urethra during surgery.