Last week I got the news that the gold standard sling for stress incontinence- the TVT - is back.
I said in a previous post that I thought they had over-reacted. This realisation and pressure from Doctors and Patients alike has meant this will now be a treatment option for women again!
It was a bizarre situation to have such a good treatment taken away but it may be that some lessons will be learned.
Patients may have learned that these devices are complex and real training and experience is required from the Doctor offering their use.
Doctors may have learned that they should seek extra training if they want to perform these procedures.
Accreditation has been suggested by the Senate enquiry... we shall see.
My choice of procedure remains the original TVT.
As someone who deals with complex urogynaecology I have concerns about Monarc / TVTO and other obturator approach slings in the long term. Whether this is because this is the most common type of sling offered by gynaecologists - and so is just due to an increased numbers issue - remains to be seen. However my own figures show no issues with the retropubic TVTs in the short, medium and long term.
In my post from 18/2/18 I mentioned the last TVT at Newcastle Private Hospital was placed in a woman who had a failed TVTO and was looking at a lifetime of incontinence.
I saw her this week and she was cured! She was so happy.