Tension-free vaginal tape (TVT-Exact™) for stress urinary incontinence: Experience of a single surgical team performing day-case procedures in three urological wards

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. 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. 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. 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. 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.