Treatment of stress incontinence

SLINGPLASTY PROCEDURES
The first slingplasty procedures were developed in Sweden 20 years ago by Ulmsted and Petros.  They are a class of treatment that has revolutionized the treatment of stress incontinence because they are so safe and effective.  All slingplasty procedures involve placement of a synthetic material under the urethra.  After the material is placed, a cystoscopy (looking in the bladder and urethra with a scope) is performed to make sure the tape is in the right place.

The tradition slingplasty - Retropubic (behind the pubic bone)

The TVT (tension-free vaginal tape) is the most common treatment of stress incontinence performed worldwide.  It belongs to a category of treatment known as a slingplasty.  The is very different form the traditional sling procedure commonly performed by urologists, which is a much larger operation.  In contrast the slingplasty can be done in Dr. Vardy’s hands in as little as 14 minutes and as an outpatient.  Success rates are in the 85-90% range with low complication rates.  The advantage of this procedure are that it has been around longer than any other slingplasty device and we therefore have more data on its efficacy, risks and adverse events.

The next generation of slingplasty - Transobturator (passed laterally through a hole in the pelvis called the obturator foramen) (BELOW)
This device was reported to be safer than the traditional slingplasty, but this has not been prooven.  Some gynecologists perform this procedure because they do not have training or priveleges to perform a cystoscopy to make sure thre procedure was done right and to make sure there is no injury to the bladder.  However, Dr. Vardy and many other experts insist that to do this procedure without looking in the bladder is dangerous and should not be done.

Uterus - The womb; where a fetus develops. During pregnancy, the uterus expands. But when a woman is not pregnant, the uterus is small, hollow and shaped like a flattened pear. Urethra - A narrow tube that carries urine from the bladder to the outside of the body. Bladder - The muscular, balloon-shaped organ inside the pelvis that holds urine. Vagina - The tube in a woman's body that runs beside the urethra and connects the uterus to the outside of the body through which blood and tissue pass out of the body during menstrual periods, which receives the penis during intercourse, and through which a baby passes during birth. Pelvic Bone - One of the three sections of the hipbone; together the two pubic bones form the front of the pelvis. GYNECARE TVT Tape (mesh) - A ribbon-like strip of mesh placed under the urethra to provide support whenever you stress this area (such as during a cough or sneeze).

The mesh is placed under the urethra and exits near the inner creases
of the thighs.  However, even thouh this procedure places mesh further away from the bladder, the only way to be sure the tape is placed in the correct position is to perform a cystoscopy (a look in the bladder for safety) after placement.

Regardless which procedure is performed you should want this procedure to be performed by a doctor who has done hundreds of these procedures, one who is considered an expert in the field and one who is capable of managing all complications associated with these procedures.  Dr. Vardy has trained over 250 physicians in these and other mesh procedures and in considered the tri-state areas leading authority in synthetic mesh procedures.