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RESEARCH PAPER
Tension-free vaginal tape (TVT-Exact™) for stress urinary incontinence: Experience of a single surgical team performing day-case procedures in three urological wards
1
Department of Urology, Faculty of Medicine, University of Warmia and Mazury in Olsztyn, Poland
2
Department of Physiotherapy, Faculty of Health Sciences, Vistula Academy of Finance and Business, Branch in Olsztyn and Kętrzyn, Olsztyn, Poland
Submission date: 2025-12-10
Final revision date: 2026-05-14
Acceptance date: 2026-05-21
Online publication date: 2026-06-18
Publication date: 2026-06-18
Corresponding author
Michal Borowik
Department of Urology, Faculty of Medicine, University of Warmia and Mazury in Olsztyn, Poland
Department of Urology, Faculty of Medicine, University of Warmia and Mazury in Olsztyn, Poland
Pol. Ann. Med. 2026;33:203-210
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Stress urinary incontinence (SUI) is common in women, but data on retropubic TVT Exact™ in regional urological units with low institutional case volumes are limited.
Aim:
To assess the efficacy and safety of retropubic TVT Exact™ across three low-volume regional urological units and to describe the feasibility of a structured day-case pathway.
Material and methods:
This retrospective descriptive multicentre cohort study included 52 women with SUI who underwent TVT Exact™ implantation between May 2015 and January 2025. All procedures were performed by the same two consultant urologists using a standardised technique. Eligibility for surgery was individualised. Day-case management was defined as discharge within 24 h and analysed descriptively.
Results and discussion:
Twenty-eight women (53.8%) were managed within the day-case pathway. Mean hospital stay was 15.4 ± 14.0 h overall and 8.4 ± 5.0 h in this subgroup, while mean operative time was 26.2 ± 2.5 min and 25.7 ± 3.8 min, respectively. There was a mean follow-up of 42.2 months overall and 47.8 months in day-case patients. An objective cure was achieved in 80.7% and 82.1%, with improvement in 13.5% and 14.3%, respectively. No major intraoperative complications occurred. Blood loss exceeded 200 mL in one day-case patient, and two erosive complications were observed overall: one bladder erosion treated with T-LESS and one vaginal erosion managed by local excision.
Conclusions:
TVT Exact™ was associated with favourable continence outcomes and low morbidity across three low-volume regional units. A structured day-case pathway appeared feasible in selected women, although the findings are descriptive and hypothesis-generating.
Stress urinary incontinence (SUI) is common in women, but data on retropubic TVT Exact™ in regional urological units with low institutional case volumes are limited.
Aim:
To assess the efficacy and safety of retropubic TVT Exact™ across three low-volume regional urological units and to describe the feasibility of a structured day-case pathway.
Material and methods:
This retrospective descriptive multicentre cohort study included 52 women with SUI who underwent TVT Exact™ implantation between May 2015 and January 2025. All procedures were performed by the same two consultant urologists using a standardised technique. Eligibility for surgery was individualised. Day-case management was defined as discharge within 24 h and analysed descriptively.
Results and discussion:
Twenty-eight women (53.8%) were managed within the day-case pathway. Mean hospital stay was 15.4 ± 14.0 h overall and 8.4 ± 5.0 h in this subgroup, while mean operative time was 26.2 ± 2.5 min and 25.7 ± 3.8 min, respectively. There was a mean follow-up of 42.2 months overall and 47.8 months in day-case patients. An objective cure was achieved in 80.7% and 82.1%, with improvement in 13.5% and 14.3%, respectively. No major intraoperative complications occurred. Blood loss exceeded 200 mL in one day-case patient, and two erosive complications were observed overall: one bladder erosion treated with T-LESS and one vaginal erosion managed by local excision.
Conclusions:
TVT Exact™ was associated with favourable continence outcomes and low morbidity across three low-volume regional units. A structured day-case pathway appeared feasible in selected women, although the findings are descriptive and hypothesis-generating.
REFERENCES (37)
1.
Haylen BT, de Ridder D, Freeman RM, et al. An International Urogynecological Association/International Continence Society joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J. 2010;21(1):5–26.
2.
Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology of lower urinary tract function: Report from the Standardisation Subcommittee of the International Continence Society. Neurourol Urodyn. 2002;21(2):167–178.
3.
Minassian VA, Drutz HP, Al-Badr A. Urinary incontinence as aworldwide problem. Int J Gynaecol Obstet. 2003;82(3):327–338.
4.
Melville JL, Katon W, Delaney K, Newton K. Urinary incontinence in US women: A population-based study. Arch Intern Med. 2005;165(5):537–542.
5.
Hunskaar S, Vinsnes A. The quality of life in women with urinary incontinence as measured by the Sickness Impact Profile. J Am Geriatr Soc. 1991;39:378–382.
6.
Rogers RG, Villarreal A, Kammerer-Doak D, Qualls C. Sexual function in women with and without urinary incontinence and/or pelvic organ prolapse. Int Urogynecol J. 2001;12(6):361–365.
7.
Wing RR, Creasman JM, West DS, et al. Improving urinary incontinence in overweight and obese women through modest weight loss. Obstet Gynecol. 2010;116(2Pt1): 284–292.
8.
Dumoulin C, Cacciari LP, Hay-Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2018;10:CD005654.
9.
Călinescu BC, Neacșu A, Martiniuc AE, et al. Surgical treatments for women with stress urinary incontinence: A systematic review. Life (Basel). 2023;13(7):1480.
10.
Lau HH, Davila GW, Chen YY, et al. FIGO Urogynecology and Pelvic Floor Committee. FIGO recommendations: Use of midurethral slings for the treatment of stress urinary incontinence. Int J Gynaecol Obstet. 2023;161(2):367–385.
11.
Petros PE, Ulmsten UI. An integral theory of female urinary incontinence: Experimental and clinical considerations. Acta Obstet Gynecol Scand Suppl. 1990;153:7–31.
12.
Ulmsten U, Petros P. Intravaginal slingplasty (IVS): An ambulatory surgical procedure for treatment of female urinary incontinence. Scand J Urol Nephrol. 1995;29(1):75–82.
13.
Ulmsten U, Henriksson L, Johnson P, Varhos G. An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J. 1996;7(2):81–85.
14.
Lebar V, Lukanović A, Matjašič M, Barbič M, Lukanović D. Long-term outcome of the retropubic TVT procedure for women with stress urinary incontinence: 20–25-year follow-up. Eur J Obstet Gynecol Reprod Biol. 2025;312:114110. https://doi.org/10.1016/j.ejog....
15.
Nilsson CG, Palva K, Aarnio R, Morcos E, Falconer C. Seventeen years’ follow-up of the tension-free vaginal tape procedure for female stress urinary incontinence. Int Urogynecol J. 2013;24(8):1265–1269. https://doi.org/10.1007/s00192....
16.
Borowik M, Borowik DJ, Roslan M. Effectiveness and safety of the TVT Exact midurethral tape for stress urinary incontinence in low-volume centers: A long-term follow-up. Ann Case Rep. 2025;10:2385. https://doi.org/10.29011/2574-....
17.
Broś-Konopielko M, Chmielewski G, Jodzis A, Teliga-Czajkowska J, Czajkowski K. Long-term effectiveness of Tension-Free Vaginal Tape (TVT) procedure– twelve years after surgery. Fam Med Prim Care Rev. 2017;19(3):196–200. https://doi.org/10.5114/fmpcr.....
18.
Nilsson CG, Kuuva N. The tension-free vaginal tape procedure is successful in the majority of women with indications for surgical treatment of urinary stress incontinence. BJOG. 2001;108(4):414–419.
19.
McAchran SE, Goldman HB. Contemporary length of stay and resource utilization when using afast-track regimen for midurethral sling surgery. Urology. 2009;74(3):531–534. https://doi.org/10.1016/j.urol....
20.
Medical Advisory Secretariat. Midurethral slings for women with stress urinary incontinence: An evidence-based analysis. Ont Health Technol Assess Ser. 2006;6(3):1–61.
21.
Laudano MA, Seklehner S, Chughtai B, et al. Cost-effectiveness analysis of tension-free vaginal tape vs Burch colposuspension for female stress urinary incontinence in the USA. BJU Int. 2013;112(2):151–158. https://doi.org/10.1111/bju.12....
22.
Lin ZW, Li WH, Qu H, et al. Therapeutic efficacy of retropubic tension-free vaginal tape for female stress urinary incontinence under day surgery mode. Zhonghua Yi Xue Za Zhi (Chinese). 2025;105(36):3195–3200.
23.
Brennand EA, Quan H. Evaluation of the effect of surgeon’s operative volume and specialty on likelihood of revision after mesh midurethral sling placement. Obstet Gynecol. 2019;133(6):1099–1108. https://doi.org/10.1097/AOG.00....
24.
Karmakar D, Mostafa A, Abdel-Fattah M. Anew validated score for detecting patient-reported success on post-operative ICIQ-SF: A novel two-stage analysis from two large RCT cohorts. Int Urogynecol J. 2017;28(1):95–100. https://doi.org/10.1007/s00192....
25.
Skorupska K, Grzybowska ME, Kubik-Komar A, Rechberger T, Miotla P. Identification of the Urogenital Distress Inventory-6 and the Incontinence Impact Questionnaire-7 cutoff scores in urinary incontinent women. Health Qual Life Outcomes. 2021;19(1):87. https://doi.org/10.1186/s12955....
26.
Nambiar AK, Arlandis S, Bø K, et al. European Association of Urology guidelines on the diagnosis and management of female non-neurogenic lower urinary tract symptoms. Part 1: Diagnostics, overactive bladder, stress urinary incontinence, and mixed urinary incontinence. Eur Urol. 2022;82(1):49–59. https://doi.org/10.1016/j.euru....
27.
Schiøtz HA, Svenningsen R, Kulseng-Hanssen S. Comparison of retropubic midurethral slings in the treatment of female stress urinary incontinence. Int Urogynecol J. 2020;31(4):711–716. https://doi.org/10.1007/s00192....
28.
Kuuva N, Nilsson CG. A nationwide analysis of complications associated with the tension-free vaginal tape (TVT) procedure. Acta Obstet Gynecol Scand. 2002;81(1):72–77. https://doi.org/10.1034/j.1600....
29.
Kulseng-Hanssen S. The development of a national database of the results of surgery for urinary incontinence in women. BJOG. 2003;110(11):975–982.
30.
Dyrkorn OA, Kulseng-Hanssen S, Sandvik L. TVT compared with TVTO and TOT: Results from the Norwegian National Incontinence Registry. Int Urogynecol J. 2010;21(11):1321–1326. https://doi.org/10.1007/s00192....
31.
Thubert T, Canel V, Vinchant M, Wigniolle I, Fernandez H, Deffieux X. Bladder injury and success rates following retropubic midurethral sling: TVT Exact™ vs. TVT™. Eur JObstet Gynecol Reprod Biol. 2016;198:78–83. https://doi.org/10.1016/j.ejog....
32.
Marschke J, Reisenauer C, Mikkola TS, Schwab F, Tunn R, Huebner M. Comparison of two retropubic tension-free vaginal tape procedures in women with stress urinary incontinence: A randomized controlled multicenter trial. Arch Gynecol Obstet. 2019;299(4):1015–1022. https://doi.org/10.1007/s00404....
33.
Aniuliene R, Aniulis P, Skaudickas D. TVT Exact and midurethral sling (SLING-IUFT) operative procedures: A randomized study. Open Med (Wars). 2015;10(1):311–317. https://doi.org/10.1515/med-20....
34.
Porena M, Costantini E, Frea B, et al. Tension-free vaginal tape versus transobturator tape as surgery for stress urinary incontinence: Results of amulticentre randomised trial. Eur Urol. 2007;52(5):1481–1490. https://doi.org/10.1016/j.euru....
35.
Teo R, Moran P, Mayne C, Tincello D. Randomized trial of tension-free vaginal tape and tension-free vaginal tapeobturator for urodynamic stress incontinence in women. J Urol. 2011;185(4):1350–1355. https://doi.org/10.1016/j.juro....
36.
Ingber MS, Stein RJ, Rackley RR, et al. Single-port transvesical excision of foreign body in the bladder. Urology. 2009;74(6):1347–1350. https://doi.org/10.1016/j.urol....
37.
Przudzik M, Borowik M, Łesiów M, Łesiów R. Transvesical laparoendoscopic single-site surgery as avaluable option to remove eroded materials from the bladder: Single-center experience and areview of the literature. Int Urol Nephrol. 2019;51(2):247–252. https://doi.org/10.1007/s11255....
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