Post Tension-free Vaginal Tape Voiding Difficulties: Prevention and Management

One of the frequent complications of tension-free vaginal tape (TVT) is postoperative urinary retention. Over-tight tape is the main cause of early postoperative urinary obstruction. Prevention and early correction of this complication may shorten rehabilitation and improve therapeutic results. Three recurring factors might have led to the postoperative urinary obstruction by overcorrection of the mid urethra: concomitant performing of anterior colporrhaphy; excessive effort applied to overcome occasional difficulties in separating the plastic TVT sleeves; use of the cough method for fine adjustment of the TVT tape. Ten women suffering from post TVT urinary retention are presented: 6 women with mild urinary retention were managed by repeated catheterizations of the bladder, while 4 women with severe postoperative urinary obstruction were treated surgically to release the tape. Since treatment all patients are voiding normally and continent. A new surgical approach for treatment of complete urinary obstruction after the TVT operation is described.