Urinary Incontinence

Surgery is targeted at the symptom of stress incontinence and the condition of urodynamic stress incontinence. Surgery in this circumstance is generally effective with around a 90% success rate.

Since 1998, when the Tension-free Vaginal Tape (TVT) came to Australia (Professor Haylen performed the first procedure in August that year), surgery for urinary incontinence has become minimally invasive and very effective, involving generally just one or two nights stay in hospital and a relatively short recovery.

Over 95% of Professor Haylen’s continence surgery involves the insertion of tapes, either alone or in conjunction with surgery for prolapse. There is a very limited role for the traditional abdominal continence procedure, called the colposuspension (also highly successful) if abdominal surgery is otherwise required (most commonly for a large fibroid uterus).

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Tension-Free Vaginal Tapes

Professor Haylen used the Gynecare “Tension-free Vaginal Tape (TVT)” up to October 2005. In the last 12 years, he has only used Boston Scientific Tapes, firstly the Advantage Tape and, over the last 4 years, the more compact Advantage “Fit” Tape. From late 2020, the Advantage “Fit” Tape: (Boston Scientific) was not available and a modified (smaller) Gynecare Tension-free vaginal tape was used.

Tension-free vaginal tape

Professor Haylen has performed around 5000 tape procedures, to his knowledge, possibly the largest series in Australia and one of the largest series worldwide.

Tape procedures, with or without prolapse or other procedures, are generally performed under a spinal (epidural) block. This allows for the patient to cough with a moderately full bladder after the tape has been inserted. This helps to ensure the adjustment (tension) of the tape is sufficient to stop the leakage. Hence, it contributes to a higher success rate for curing incontinence.

Surgery Aftercare

Professor Haylen arranges for a surgical follow-up visit within 10 days of the procedure to make sure all is well. In a very small number of cases, adjustment of the tape is required. This needs to take place within the 14-16 days after surgery.

Light duties (lifting no more than 5Kg) are required in the first 10 days. Return to most work activities is allowed after this. Driving after the tape procedure is allowed after 4 days.

There are vaginal sutures, which dissolve over 4 weeks restricting intercourse (if applicable) over this time. Sporting activities can be resumed from 4 weeks post-op.

Colposuspension

The colposuspension uses vaginal tissue to elevate the bladder neck. Stitches link the vagina to the strong ligaments overlying the pubis. This is a different way of curing incontinence from the tapes, which uses a sling to support the middle of the urethra. The colposuspension has been a very effective procedure since first developed by Burch in 1961.

Colposuspension

Bladder

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Practice Contact Phone Numbers: St Vincent’s Clinic 02 8382 6983; Mater Clinic 02 9950 4610

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