New Surgery for Stress Incontinence
July 1, 2006
Vincent Lucente, MD is first in world to perform new FDA-approved technique for urinary stress incontinence
ALLENTOWN, PA - Internationally recognized reconstructive pelvic surgeon Vincent Lucente, MD is first in the world to perform the corrective procedure, TVT Tension-free Support, using the new FDA-approved placement device, TVT Secur, for trans-vaginal tape to correct stress urinary incontinence.
Dr. Lucente, founder and Medical Director, The Institute for Female Pelvic Medicine & Reconstructive Surgery and the Center for Pelvic Health, St. Luke's Hospital & Health Network, performed the technique July 26, 2006 at St. Luke's Hospital - Allentown Campus.
The technique is performed without external skin incisions, according to Dr. Lucente. "The clinical trials have shown virtually no post-operative pain. With these kinds of advancements in clinical care, more women will be encouraged to seek treatment for stress urinary incontinence, a condition that affects over 19 million women in the United States alone," he says.
Female stress urinary incontinence is caused predominantly by an improperly functioning urethra; it is not a problem of the bladder. "Normally, the urethra, when properly supported by strong pelvic floor muscles and healthy connective tissue, maintains a tight seal to prevent involuntary urine loss," says Dr. Lucente. "When a woman suffers from stress urinary incontinence, however, weakened muscle and pelvic tissue don't support the urethra adequately. As a result, the urethra doesn't maintain a tight seal during exercise or other movement and urine escapes."
TVT Tension-free Support combines the use of safe material, PROLENE polypropylene mesh, and a variation of a traditional operation known as a sling procedure to correct stress urinary incontinence. The PROLENE mesh is inserted through the vagina and positioned underneath the urethra, creating a supportive sling. During movement or exercise, the mesh supports the urethra, allowing it to maintain its seal to prevent urine loss. The tape, therefore, uniquely provides support only when needed, without any unnecessary tension on the urethra (tension-free).
The procedure can be completed within 15 minutes under local anesthesia and patients may return home the same day. TVT Tension-free Support offers short recovery time with minimal pain. Most patients will not require catheterization after surgery. In contrast, many surgical treatments currently in use for treating stress urinary incontinence involve general anesthesia, extensive surgery and a lengthy recuperation.
No traditional surgical anchors are required. As the tape passes through several pelvic tissue layers, friction is created, which secures the tape in place. Over time, the natural in-growth of tissue into the mesh further secures the tape.
Since the procedure is usually performed under local anesthesia with IV sedation any necessary adjustments to the mesh tape can be made intra-operatively utilizing a cough test, which improves placement of the sling and the success rate.
The mesh tape loosely supports the middle of the urethra and therefore, uniquely provides support only when needed without tension. This reduces the need for catheterization.
In February 2005, Dr. Lucente was first in the world to perform a revolutionary mesh procedure for pelvic floor repair, known as PROLIFT.