Tension Free Vaginal Tape Underneath Bladder Base: Does It Prevent Cystocele Recurrence?

Main Category: Urology / Nephrology
Also Included In: Women's Health / Gynecology
Article Date: 19 Jan 2009 - 4:00 PDT

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UroToday.com - With the use of TVT tapes, it occurred to me that they could perhaps be utilized as reinforcement to anterior colporraphy sutures. This was before tension free vaginal meshes were introduced in the local market.

Consequently, I began placing them after completion of the anterior colporraphy technique - not as originally intended, underneath the mid-urethra, but instead underneath the bladder base. Of course, the passage of the needles was carried out before starting with the colporraphy sutures. Then, the anterior colporraphy in typical manner ensued, and afterwards the previously placed vaginal tape was fixed with Vicryl sutures underneath the bladder base. Initially I used both TVT and TOT tapes, but in a further series of cases, I used only TOT tapes in order to establish a more homogeneous study.

I must say it is appealing to use these tapes in this manner, as they are able to serve as a second-line option to vaginal meshes. The follow-up data are encouraging since thus far no dyspareunia in any of the patients has been noted.

This usage could evolve to become a solution for younger patients, however, longer follow up is required, and of course a wider ranging study.

Written by Theoharis Tantanasis, MD as part of Beyond the Abstract on UroToday.com

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