New Procedure Offers A Less

Invasive Treatment For Incontinence

Women with common incontinence problems now have a new option to traditional surgery – one that is less invasive and promises a faster recovery with fewer complications.

Danbury Hospital is among the first health-care facilities in the state to offer this less invasive surgical procedure. Called the TVT Tension-free Vaginal Tape System, the new procedure uses a kind of tape made from the same polypropylene material as sutures to hold the bladder and urethra in place.

The procedure works best on women with a condition called “stress incontinence,” which can be caused by a weakness in the bladder after the stress of childbirth or by a genetic abnormality. Other types of incontinence, such as “urge incontinence,” are best treated with medications, biofeedback, collagen injections or devices.

More than 11 million women suffer from stress incontinence, many of whom don’t seek treatment because they are embarrassed to talk about it with their doctors, or think it is a normal part of aging. Incontinence also affects about 2 million men.

“Only about 10 percent of women sufferers will ever seek help,” says James Xenophon, MD, of the hospital’s Department of Obstetrics and Gynecology and the Candlewood Obstetrics and Gynecology Group in Brookfield. Dr Xenophon, a urogynecologist, has been trained to perform the new procedure. “[The problem] is very common, but not normal, and can be easily treated,” he adds.

With stress incontinence, leaking usually occurs after a woman laughs, coughs, sneezes or exercises, and can be either minor or severe. “This is a problem which is growing by leaps and bounds,” he says, as more women age.

Other surgical options, including bladder tucks, were not always the treatment of choice with women because they required general anesthesia and extensive incisions. Recovery was longer and results sometimes not long-lasting.

The new procedure, however, can be done in 30 minutes under local anesthesia, promising less pain and a shorter recovery time. Patients usually go home the same day, or can stay the night. The procedure is under the general category of “sling procedures,” because a sling is made of tape to pull the bladder up and hold it in place, according to Dr Xenophon.

In very simple terms, the “sling,” made of polypropylene tape, is inserted through a tiny incision in the vagina with a special instrument and wrapped around the bladder. Another tiny incision is made in the pubic hairline, leaving a woman with a very tiny scar that is well hidden.

“The procedure is nice because it has an 85 to 87 percent success rate,” said Dr Xenophon. It is also expected to have good long-term efficacy, he adds. In earlier procedures, the material often used to create the “sling” deteriorated and needed to be replaced. “The TVT system uses the same material used in sutures, so we know it will be good for the body over time.”