Tension Free Vaginal Tape

What is Tension Free Vaginal Tape?

Tension Free Vaginal Tape (also referred to as "TVT" or "TVTSling") is a minimally invasive surgical procedure preferred by manydoctors for treating some women with female urinary incontinence. The Tension Free Vaginal Tape procedure can be performed under local or minimal anesthesia and takesabout 30-45 minutes to perform. The recovery period following the procedure is short, and patients experience few complications and minimal scarring after surgery. 

The actual Tension Free Vaginal Tape is a ribbon-like strip that acts like ahammock to support a woman's urethra and the Tension Free Vaginal Tape, onceplaced, stops urine leakage by supporting the woman's urethra. 

Tension Free Vaginal Tape has a success rate of 98% after 7 Years based on a follow-upstudy on the Tension Free Vaginal Tape (TVT) Procedure; International Urology, IUGA Abstract #116 (89): October 2003).

Whatis "Colposuspension" surgery?

Age and vaginal childbirth takes it toll on women's pelvic organs.  

"FemaleUrinary Incontinence" is one of the problems most (over 50%) women who havedelivered babies vaginally have to contend with.  Women with Female UrinaryIncontinence "leak" urine when they strain,  cough, laugh or run.This condition is also called "stress urinary incontinence" meaning the stress of physical activity, not emotionalstress is causing her to "leak" urine.  

The problemsassociated with female urinary incontinence are corrected in the the "floor" of thewoman's pelvis by several methods or types of surgeries - one of which is calledColposuspension

Awoman's pelvic floor is a sheet of special muscles and ligaments that stretch across the inside of thefemale pelvis. Women can feel it "tighten" when they try to hold backthe flow of urine - or when they strain,  cough, laugh or run. The uterus andbladder are located above the pelvic floor. The vagina and the opening of the bladder (the urethra) pass through thepelvic floor. If the pelvic floor weakens, the uterus and bladder "drop" down. The control of the urine isthereby weakened. 

Colposuspensionsurgery strengthens the pelvic floor to lift, or "suspend" the uterus and bladder back upto their correct position within the woman's pelvis

Colposuspensioncomes from the Greek word for vagina - "colpos."

Whatis "Urethropexy"?

Urethropexy is a surgical procedure where the support of a woman's urethra isre-supported through sutures that surround the urethra's pelvic floor  and vaginal tissues toher pubic bone.

Whatis "vulvar health"?

Vulvarhealth is a term that covers the many health issues of a woman's - or younggirl's vulva.  This includes vulva care, gynecology,feminine hygiene, vaginal health, vaginalhygiene, menstruation, and the changes inwomen's vulvas from menarcheto menopause. 

Husbandsand fathers - as well as women and mothers need to learn more about vulvahealth, to provide the care and support the special women in their lives mayneed. Husbands and fathers have a unique role in providing the healthcare andknowledge, especially those single dad's that have young daughters.  

Vulvarhealth is an area that is related to the health and care of the vulva. Manymen and women are afraid to use the term "vulva" due to its'technical, and medical sound, and most simply prefer to call the vulva a"vagina."  Yet that would be incorrect.  The vagina is justone part of the vulva. Nobody, with the exception of a doctor, can see a woman'svagina, and only he/she can see a woman's vagina by looking into the vagina,using a special instrument called a speculum.  

It'stime to begin calling a "spade a spade."  When mother's andfathers are bathing, or toilet training their daughters, they should explainthat the vulva, which is on the outside, has several parts, and that her vagina,is on the inside.   

Whatis/are Vulvar Diseases?

Vulvodynia-chronicvulva discomfort, vulvar vestibulitis,dysesthetic vulvodynia

Vulvardystrophy-broad term to describe various epithelial changes.  In 1987-ISSVDInternational Society Studies of Vulvar diseasefound the following symptoms; a. nonneoplastic.  b.intraepithelialneoplasms - spuamous cell CIS c. nonsquamousintraepithelial neoplasia

LESIONSAND DISEASES

HSV

Womenwith HSV reports flu like symptoms, pain, itching, UTI symptoms, vaginaldischarge, sores on labia, anus, perineum, buttocks, thighs, dyspareuniaVesicles, ulcers, pustules, tender adenopathy, 70% will have lesion in vagina

Syphilis

Womenwith syphilis report painless sores in vulvovaginal area.  Primary - red,round, firm ulcer with granular base with well-formed edges. Secondary- moist,mucus lesions which resemble herpes. Moist cutaneous lesions called condylomalata, appear flat and gray. Adenopathy, maculopapular rash.

CondylomaAcuminata

Womenwith CA report new bump: itching, generalized pruritus, last pap.  Warty,flesh colored, sharp and pointed, cauliflower, + acetowhite

Candidiasis

Womenwith candidiasis report burning, itching, discharge, dyspareunia, vulvar edema,h/o diabetes, high carbohydrate diet, use of AB, frequent intercourse, h/osteroids, HIV.

Bartholin'sGland Infection

Womenwith barthloin's gland infections eportr unilateral bump. Reports active sex,recent trauma, new sexual partner leading to infections, fever, complaints ofpain with intercourse, warmth, tender to touch, difficulty walking, sitting. H/OCrohn’s disease.

ContactDermatitis

Womenwith contact dermatitis report vulvovaginalitching, rash, and increased incidence when wearing tight pants.  The vulvaskin is red, inflamed, edematous, vesicles or bullae if severe, weeping,crusting and lichenification. 

LichenSclerosus

Womenwith LichenSclerosus report vulvovaginal itching, familiallinkage, edema, superficial ulcers, burning, area feels different.  Womenwith LichenSclerosus in all ages, show symptoms in their clitoris, prepuce of theclitoris (the "prepuce" is the clitoral "hood"  thatcovers the clitoris when not the clitoris is not erect or aroused), labia majora,labia minora,edema, scarring, color, appearance of tissue paper of skin.

LichenPlanus - Women with lichen planus report vulvar itching, burning, withvulvovaginitis symptoms on mucosal surface of vulva. Dyspareunia, painfulerosive areas. Bleeding on contact, stenosis of introitus. The vulva has whiteraised lesion with reticular, lacy pattern. Erosive reddened area bordered byreticular white epithelium. External labia has appearance of lichen sclerosus +acetowhite. Other signs may appear in her mouth.

VulvarNeoplasm-Melanoma - affects mostly postmenopausal women that affects theclitoris and labia majora. Usually no symptoms.

VulvarIntraepithelial Neoplasm -  Pruritus, vulvar burning, pain, discharge,bleeding, may report urethra, vaginal and anal symptoms.  White, dk, red,ulcerated, raised warty, or nodular lesions. Labia mayora most common site,minora, clitoris and perineum. 

Vulvodynia(Vulvar Pain Syndrome) - Various levels of burning, stinging, pain, dryness,irritation, rawness. No pruritus. May report long term hx.

VulvarVestibulitis is a burning, dysuria, frequency, with repeatedyeast infections or HPV.  Significant/severe pain with touch or attemptingintercourse.

Paget'sDisease

VulvarPruritis, usually affecting older women. The vulva appears red/tan withscaly lesions.

What is Vulvar Cancer?

Vulvarcancer is cancer that is found in and on the vulva. 

Whatis Vulvar Vestibulitis?

VulvarVestibulitis is a condition which causes redness and pain of the vestibule. VulvarVestibulitis is an inflammation of this skin and the mucous secreting glandsfound in the skin. The mucous secreting glands are called the lesser vestibularglands.  

VulvarVestibulitis may include all the area around the opening of the vagina butis normally seen in the lower part of the vaginal opening.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VulvarVestibulitis occurs in women of all ages. It can occur in women who aresexually active and also in women who have never been sexually active.  

Manywomen with this problem have suffered physically and emotionally for months oryears, have seen a number of physicians, and have tried many unsuccessfultreatments in search of relief.  

Whatare the signs and symptoms of VulvarVestibulitis?

*  Severe pain with pressure (for example: biking, exercise,tight fitting clothes ).

Vaginal entry such as tampon use or intercourse. 

Burning, stinging, irritation, or raw sensation within thevestibular area.

* Vestibular redness 

The urge to urinate frequently or suddenly.   

How is Vulvar Vestibulitisdiagnosed (identified)?

Yourdoctor or health care provider will examine the vulva and vestibule to identifythe common skin changes seen with vulvarvestibulitis. Pain is usually felt if the vestibule area is touched with acotton tipped applicator. A sample of your vaginal discharge is collected andtested to rule out infection.

Whatcauses Vulvar Vestibulitis? 

The exact cause is unknown, but many studies are being conducted to determinethe cause of vulvar vestibulitis.  

Thefollowing factors have been associated with vulvarvestibulitis:

HPV (Human Papilloma Virus)
Chronic Yeast Infections
Chronic bacterial infections 
Chronic changes of pH (acid-basebalance in the vagina)
Chronic use ofchemicals/irritants such as detergents, soaps, spermicides or lubricants.

What is the treatment for VulvarVestibulitis?  

Treatment may include any of the following:  

*  Follow the Guidelines for Vulvar Skin Care
Steroid Ointments 

How it is used: A thin layer is applied to the vulvovaginalareas. 

How it Works: Decreases redness, irritation, and burning. Caution: Use only asprescribed by your doctor. Overuse may result in thinning of the skin which willmake your problem worse rather than helping it.

Trichloroacetic Acid (TCA) may beused in some cases as determined by the severity of the symptoms you have. TCAis a chemical that is used to destroy small areas of the irritated skin allowingnew healthy skin to grow in its place. 

Interferon Injections are used toincrease your body's response to infection. 

Helpful treatment hints for VulvarVestibulitis:

Vitamin A and D Ointment  Howit is used: Apply to the areas of discomfort.
How it Works: Protects the skin, decreases irritation, heals, and soothes.

Lidocaine Gel may be prescribed after initial treatment. 
How it is used: Apply lidocaine gel to thevulvovaginal areas of discomfort. 
How it Works: Numbs areas before intercourse.
Caution: After applying, wait until area becomes less sensitive beforeintercourse. Burning may occur for a short time ( 5 to 10 mins.) after the gel is applied.

*  Witch Hazel Pads (TUCS Pads) How it is used: Apply to the vulvovaginalareas of discomfort. 
How it Works: Decreases burning and irritation after intercourse and urinating.

Cleansing Bottle - Pour plain luke-warm water over the vulva afterurinating to remove urine from irritated area.  

Calcium Citrate Tablets- How it is used: Take orally 1200-1800mg.elemental calcium every day. How it Works: Thought to decrease certain crystalsin the urine which may cause burning. 

Cranberry Juice  How itis used: Drink an 8oz. glass every day. 
How it Works: Increases the acid content of the urine to decrease bladderirritation. 

Limit High Oxalate Foods - May decrease amount of oxalate crystalsin urine. Oxalate crystals cause urinary symptoms such as the urge to urinatefrequently or suddenly. 

*  Baking Soda Soak- Soak in luke warm bath water with 4 to 5 tablespoonsof baking soda to help soothe vulvar itching and burning. Soak 1 to 3 times aday for 10 to 15 minutes. If you are using a sitz bath, use 1 to 2 teaspoons ofbaking soda.

Whatis a Vaginal Vault Prolapse?

The vaginal vault is the area at the top of the vagina, next to and adjacent tothe cervix. It can only “fall” or descend downwards toward the introitus, orthe entrance of the vagina, after a woman's womb has been removed(hysterectomy). Vaginal Vault Prolapseoccurs in about 15% of women who have had a hysterectomy for uterine prolapse,and in about 1% of women who have had a hysterectomy for other reasons.

Whatis Pelvic Organ Prolapse?

PelvicOrgan Prolapse is a very common condition, particularly among older women.It's estimated that half of women who have children will experience some form ofPelvic Organ Prolapse in later life. Many women, particularly because they mayno longer be sexually active, and fail to continue receiving their annual pelvicexams, don't seek help from their doctor. Therefore, the actual number of womenaffected by Pelvic Organ Prolapse is unknown. 

Pelvic Organ Prolapse may also becalled; genital prolapse, pelvic relaxation, pelvic prolapse, uterine prolapse,uterovaginal prolapse, pelvic floor disorder, urogenital prolapse or vaginalwall prolapse.

Whatis Pelvic Prolapse?

PelvicProlapse is another term used for "pelvic organ prolapse." Pelvic prolapse is a very common condition, particularly among older women. It'sestimated that half of women who have children will experience some form ofPelvic Organ Prolapse in later life. Many women, particularly because they mayno longer be sexually active, and fail to continue receiving their annual pelvicexams, don't seek help from their doctor. Therefore, the actual number of womenaffected by Pelvic Organ Prolapse is unknown. 

Pelvic Prolapse may also be called; genitalprolapse, pelvic relaxation, uterine prolapse, uterovaginal prolapse, pelvicfloor disorder, urogenital prolapse or vaginal wall prolapse.

What is a Prolapsed Uterus?

AProlapsed Uterus refers to a collapseduterus, or descended uterus, or other change in the position of the uterus inrelation to the surrounding structures within the pelvis. The pelvis containsmany soft tissue structures vital to normal body functions, supported primarilyby the diaphragms, layers of muscles, fibrous coverings called fasciae, andvarious ligaments and tendons. These soft tissues of the pelvis derive theirultimate support from the bony pelvis. 

A Prolapsed Uterus may be one of three types,depending on the severity:

• First-degree prolapse occurs when the uterus sags downward into the upper
vagina.

• Second-degree prolapse occurs when the cervix is at or near the outside ofthe
vagina.

• Third-degree prolapse (sometimes referred to as total prolapse) occurs whenthe entire uterus extends outside the vagina.

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Adhesiolysis    Birth Control Sponge    Bladder Neck Suspension   Cervical Cancer     CervicalMucus Method     

Clitoral Adhesions
     Colposuspension    Depression Help     EssentialTrace Minerals     

Female Sexual Health
     FemaleUrinary Incontinence    FeminineDeodorant   Feminine Hygiene 

Feminine Itching
     FeminineOdor     Feminine Wipes  Gynecology for Guys    Gynecologic Disorders 

Gynecologic Laparoscopy
     GynecologicUrology   Labial Adhesions    Menarche     Menorrhagia

Menstrual Disorders
    MenstrualHygiene    Menstruation  Natural Hormone Cream    NaturalProgesterone Cream

Organic Cotton Tampons    Organic For Life    OrganicTrace Minerals     PainfulPeriods     PelvicAdhesions

Pelvic Floor Dysfunction    Pelvic Floor Reconstruction   Pelvic Inflammatory Disease    Pelvic Laparoscopy

Pelvic Organ Prolapse    Pelvic Reconstructive Surgery   Period Protection     PolycysticOvary Syndrome

Pregnancy and Childbirth
     PrematureOvarian Failure     PremenstrualSyndrome     ProlapsedUterus     Puberty

Reconstructive Pelvic Surgery
     Sacrocolpopexy    Sanitary Protection    Suburethral Sling     TamponSafety

SymptoThermal Method
     ThermalBalloon Ablation     ToxicShock Syndrome     UrinaryTract Infections

Urethropexy
    Uro-Gynecology    Uterine Balloon Therapy    Vaginal Birth After Cesarean    Vaginal Dryness

Vaginal Hygiene     VaginalMoisturizers    Vaginal Odor    Vaginal Relaxation     VaginalSponge     VaginalVault Prolapse

Vaginal Yeast Infection
     VulvaHealth     Vulvar Diseases    Vulvar Vestibulitis    Vulvovaginal     Vulvovaginitis

 

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