The use of prophylactic antibiotics in the tension-free vaginal tape procedure: is it indicated?

The tension-free vaginal tape (TVT) surgical procedure is well established in the treatment of female urinary stress incontinence. The operation is based on a midurethral Prolene tape support. TVT is accepted as an easy-to-learn and safe minimally invasive surgical technique. Postoperative infections have been described following other surgical methods for correcting female urinary stress incontinence. Hence, prophylactic antibiotics are commonly also used in TVT to minimise this surgical complication. The aim of this analysis was to evaluate the occurrence of infection in relation to TVT and the need for prophylactic antibiotics. Out of 524 patients undergoing TVT and followed for up to 68 months, only three suffered surgical field infections within the postoperative period. The three infective processes developed with a background of retropubic haematoma formation. The literature is reviewed, and the justification for prophylactic antibiotics in the TVT operation is discussed.