Trans vaginal tape readjustment after unsuccessful tension-free vaginal tape operation

Aims: This study is aimed at evaluating a new surgical technique to deal with tension-free vaginal tape (TVT) failure. The TVT operation, described by Ulmsten in 199 5, is based on a mid urethral Prolene tape support. TVT is accepted as an easy-to-learn and safe minimal invasive surgical technique. Yet, as with other surgical methods for correction of female urinary stress incontinence, therapeutic failures occur with TVT also. Materials and Methods: Described here is a new approach for addressing this issue. Out of 344 women who underwent TVT and who were followed for up to 55 months, four (1.2%) requested to be reoperated on the grounds of a diagnosis of operative failure. These four women were treated by trans vaginal readjustment of the tape. Results: Three out of the four reoperated patients reported subjective continence, subsequently confirmed clinically. The fourth patient, although suffering residual minor urinary leakage, declined further interventions. Conclusions: The readjustment technique seems effective, easy, and safe for the treatment of failed TVT operations. More experience is needed prior to suggesting this technique as a recommended approach. (C) 2004 Wiley-Liss, Inc.