What is a midurethral sling (e.g., TVT) procedure?

• A. A major open abdominal surgery removing bladder.
• B. A catheter-based procedure to divert urine.
• C. A vaginal implant to enlarge urethra for drainage.
• D. A minimally invasive sling placed under the urethra to provide support and prevent leakage during increased abdominal pressure.

Answer: (D)

A midurethral sling is a minimally invasive surgical treatment for stress urinary incontinence that places a small piece of tape or mesh under the mid-portion of the urethra to provide support. The sling acts like a backboard, so when abdominal pressure rises from coughing or sneezing, the urethra is better supported and less likely to leak. TVT is a well-known example of this approach. It does not involve removing the bladder, diverting urine with a catheter, or enlarging the urethra; instead it reinforces the natural urethral support to prevent leakage.