Understanding Sling Procedures for
Urinary Incontinence in Women: What is Transobturator Tape Surgery?
Urinary incontinence—There are mainly two types of
incontinence: Urge and stress. While urge incontinance is defined simply as an
involuntary leakage of urine after a sudden intense urge; stress incontinance
is involuntary leakage when your bladder is under pressure, like when your
laughing, sneezing, jumping or even doing exercise like pilates. Specifically stress urinary incontinence—is a
common issue affecting many women, especially after childbirth or as they age.
One of the most effective and minimally invasive treatments for this condition
is a sling procedure, particularly the transobturator tape (TOT) surgery.
What is a Sling Procedure?
A sling procedure involves placing a small piece of
surgical mesh (a type of supportive material also used to repair hernias) under
the urethra, which is the tube that carries urine out of the body. The sling
acts like a hammock to support the urethra and bladder neck, helping prevent
leakage during activities that put pressure on the abdomen. It also helps
maintain the right angle between urethra and bladder in order not to leak any
urine.
What Makes Transobturator Tape (TOT)
Different?
There are several types of sling procedures, and TOT
is one of the most commonly performed today. In TOT surgery, the mesh is placed
through small incisions made in the groin area and passed under the urethra
through a natural space called the obturator foramen. This approach avoids
going behind the pubic bone, which can lower the risk of certain complications
such as bladder, bowel and neurovascular injuries.
Benefits of TOT Surgery:
- Minimally invasive: Small incisions mean a faster recovery.
- Effective: Most women experience significant improvement or
complete resolution of leakage.
- Quick recovery: Many patients return to normal activities within a
few days to a week.
- Performed under local or spinal anesthesia: Reducing the need for
general anesthesia in most cases.
What to Expect During and After the
Procedure:
The surgery typically takes about 30 minutes and can
often be done as a day case, meaning you go home the same day. Mild discomfort,
bruising, or a feeling of tightness in the groin is normal for a few days.
You’ll be advised to avoid heavy lifting, exercise, and sexual activity for a
few weeks to allow healing. In order for the TOT mesh to bond with your body,
you would be advised to refrain from activites like lifting heavy stuff and use
appropriate supplements to relieve constipation if you have any.
Are There Any Risks?
Like any surgical procedure, there are potential
risks. These may include infection, difficulty emptying the bladder
temporarily, pain in the groin or thigh area, or in rare cases, mesh
complications. However, serious problems are very uncommon, and your surgeon
will discuss these with you beforehand.
What Is the Success Rate of This
Surgery?
TOT surgery has a success rate of more than 90% in
short term and studies have shown that many women may continue to enjoy the
benefits of this procedure. Long term success rates lay around 70-80% around 10
years after the surgery.
Is It Right for You?
If you’re dealing with stress urinary incontinence and
conservative treatments (like pelvic floor exercises) haven’t helped, sling
surgery—especially TOT—might be a good option. This type of surgery can also be
used together with prolapsus surgeries, if you have prolapsed uterus and
bladder. A consultation with a specialist can help determine if you’re a
suitable candidate.
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Author &
Surgeon: Prof. Cem Iyibozkurt
Posted: Apr 25, 2025 at 17:24 UTC
Last Updated: Apr 25, 2025 at 16:02 UTC
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