TOT anti-incontinence surgery

What is TOT surgery?

There are several types of incontinence, with SUI (stress urinary incontinence), more commonly known as stress incontinence, requiring surgery. Of the several treatment options for stress incontinence, TOT (transobturator tape) surgery is preferred. During the operation, the urethra’s anatomical abnormality is compensated for by the transobturator tape implantation. The operation should always be performed under spinal anesthesia, as communication with the patient during the operation is very important. During surgery, a synthetic tape is implanted in the anterior vaginal wall or between the urethra and the anterior vaginal wall, which raises the urethra to its original position, thus eliminating incontinence. During surgery, the bladder is filled to simulate its subsequent urination position, so we can control the position of the tape and the urethra by requesting the patient to contract their abdominal muscles to initiate urination. After the operation, we can prevent urine leakage that was previously caused by physical or other types of stress. 

What preliminary tests are required?

A laboratory test and an anesthetic consultation are required prior to TOT surgery, and an ECG and chest x-ray are also required for patients over 40. For patients with internal medical conditions, a consultation with an internist is also required.

How should I prepare for TOT surgery?

It is recommended to schedule the surgery outside the menstrual period. The patient should time the post-op recovery period so that it is entirely restful.

What is the procedure for TOT surgery?

The surgery is performed under spinal anesthesia. After anesthesia, catheter placement and the required disinfection procedures, the anatomical points are located by opening the vaginal wall to which the tape can be attached. The essential part then takes place: checking the operation, testing the bladder. The bladder is filled with physiological saline to observe at which point and angle of the urethral fold we can reestablish a good closure function. The operation is always followed by antibiotic treatment. Strict rest is necessary after the operation, as the transobturator tape can move at any time under physical stress, rendering the operation unsuccessful. Therefore, after the operation, 4 to 6 weeks of strict physical rest are recommended, after which full recovery can be expected.

What should patients do after TOT surgery?

After surgery, sparing yourself from physical exertion is paramount, as the attachment of the surgical tape to the tissues is one of the most crucial points of the surgery. If successful, the procedure can be a permanent solution to stress incontinence. TOT surgery at Dr. Rose Private Hospital involves a one-day hospital stay. After surgery, you will need 4-6 weeks of strict rest, during which sexual activity, submerged bathing and all physical exertion should be avoided.

What is the success rate of TOT surgery?

TOT surgery is always successful, and the key is to have cooperation and feedback from the patient during surgery and the bladder-loading phase. If there are no complications during the operation or afterwards, the intervention will always be effective and efficient in eliminating stress incontinence.

What are the risks of TOT surgery?

Like all surgical procedures, TOT surgery can be associated with bleeding, injury and inflammatory complications. With antibiotic treatment before and after surgery and disinfection according to protocol, the chances of these are minimal.

TOT surgery prices

You can find our current prices on our price list.

Why choose Dr. Rose Private Hospital?

• Qualified specialists, modern diagnostic and therapeutic equipment.
• Empathetic, people-oriented approach. Our specialists always keep the comfort and safety of our patients in mind.
• Premium quality inpatient department. 3 operating theatres and 24 patient rooms with 33 beds to meet all your needs. The highest professional standards meet an exclusive healing environment where you can recover in safety and peace of mind.
• Fast and predictable appointments. Within 1-2 weeks from the first consultation with a specialist, we will arrange an appointment for the necessary intervention.

For all your gynecological complaints, feel free to contact the doctors at Dr. Rose Private Hospital.