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Transobturator Tape (TOT)

Stress Urinary Incontinence (SUI) may cause significant deterioration in quality of life. TOT is definitely one of the most effective operations to eliminate SUI. TOT has the highest cost effectiveness and uppermost risk benefit ratio compared to other surgical approaches for SUI.

A synthetic (prolene) mesh tape is placed under the bladder neck (urethra). This tape functions as a "hammock" supporting the urethra in times of stress, such as coughing, sneezing, laughing, jumping, etc.

Surgery

You have either a general anaesthetic so you are asleep or the lower half of the body is made to feel numb by a spinal anaesthetic. A small incision (about 1 to 1.5 inches, 3 cm) is made in the vagina just below the opening of the urethra (water pipe), and two 1/4 inch (0.5 cm) incisions in the inner thigh. The tape (e.g. Monarc) is positioned under the urethra and the incisions are the closed with stitches. These stitches will dissolve spontaneously. During the procedure, a telescope may also be passed through the urethra (water pipe) to examine the inside of the bladder (cystoscopy). The entire operation takes about 30 minutes.

Symptoms

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This may be right for you if you have the following symptoms:

  • Unplanned, sudden urine loss either while sleeping or during the day
  • Leakage while laughing, sneezing, jumping or performing other movements that put pressure on the bladder?
  • Trouble holding your urine as you hurry to the bathroom
  • Frequently experience a sudden and immediate urge to urinate
  • Notice a change in your frequency of urination
  • Visit the bathroom to urinate more than eight times per day
  • Currently wear pads or liners to protect against unplanned leaks
 
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