Latest advances in TVT tension-free support for urinary incontinence.

The Tension-free Vaginal Tape (TVT) procedure is the first of a new generation of minimally invasive operations for treatment of female urinary stress incontinence. A new theory of the cause of stress incontinence, the "Mid-urethra Theory," was the basis for development of the TVT operation. Systematic, prospective clinical trials have proved the TVT procedure is effective and safe in curing stress incontinence. Assessed by strict objective and subjective outcome measures, cure rates of 85% were reported, with another 5%-10% being improved significantly. The method is equally effective in groups of patients with uncomplicated genuine stress incontinence, recurrent incontinence, mixed incontinence, and those with intrinsic sphincter deficiency. Careful prospective registering of complications associated with the procedure indicate complication rates are low when proper training is provided and the operation is performed in its standardized method. Five years of follow up show a cure rate of 85%, which indicates little decline in cure rates by time. Preliminary analysis of seven-year results shows a cure rate of 81%.