The catheter straight guide does not reduce the incidence of bladder penetration during TVT placement by the experienced surgeon

Tension-free vaginal tape (TVT) is a well-established surgical procedure for treating female urinary stress incontinence. The operation, described by Ulmsten et al. in 1995, is based on a midurethral Prolene tape support. TVT is accepted as an easy-to-learn and safe minimally invasive surgical technique. Bladder perforation with sling material was described as a complication of former surgical methods for correcting female urinary stress incontinence as well as of TVT. The aim of this analysis was to determine whether the use of a straight inserter for identifying and displacing the bladder prior to inserting TVT needles reduces the occurrence of bladder penetration. Out of 524 patients undergoing TVT and followed for up to 68 months, 68 (13%) had TVT bladder penetrations, all of which were diagnosed and corrected during surgery. All but the last 50 patients had a straight inserter introduced during the procedure. The effect of this surgical step is estimated and discussed.