Urethral Sling (TOT)
Urethral sling surgery is a surgical procedure performed specifically to treat stress urinary incontinence (SUI). Stress urinary incontinence is defined as the involuntary loss of urine during activities that increase intra-abdominal pressure, such as coughing, sneezing, laughing, or lifting heavy objects. Urethral sling surgery prevents urinary incontinence by providing support under the urethra to treat this condition.
TOT (Transobturator Tape) Procedure
TOT (Transobturator Tape) surgery is a common type of urethral sling surgery. The TOT procedure is performed with a minimally invasive approach and a tape is placed to support the urethra by passing through the muscles in the groin area. This method is used to improve urine retention and reduce incontinence.
Performance of TOT Surgery
- Anesthesia: TOT surgery is usually performed under general or spinal anesthesia.
- Surgical Intervention: The surgeon makes a small incision in the vaginal wall and places a sling (band) under the urethra.
- Placement of the Band: The band is placed in a U shape under the urethra and both ends are passed through the groin area.
- Adjusting the Band: The band tightness is adjusted and the incision is closed.
- Recovery Process: The patient stays in the hospital for a while for postoperative observation and is then discharged.
Advantages of TOT Surgery
- Minimally Invasive:TOT surgery is less invasive than other incontinence surgeries and offers a faster recovery process.
- High Success Rate:TOT surgery is highly successful in treating stress urinary incontinence rate.
- Less Pain: There is less pain and discomfort after surgery compared to other methods.
TOT surgery is usually applied in the following cases
- Stress Urinary Incontinence: Women who experience urinary incontinence, especially during coughing, sneezing or physical activity.
- Urethral Hypermobility: Those who have urinary incontinence due to excessive mobility of the urethra.
- Previously Failed Conservative Treatments: Pelvic floor exercises or medical patients who have not been successful with treatments.
What is the Success Rate of TOT Surgery?
The success rate of TOT surgery is generally high. Various studies have reported that 80-90% of patients experience significant reductions or complete elimination of urinary incontinence symptoms. However, the success rate is closely related to the patient's general health, surgical experience and postoperative care.
What are the Possible Complications of TOT Surgery?
As with every surgical procedure, there may be some risks and complications in TOT surgery:
- Infection: There is a risk of infection in the surgical area or urinary tract.
- Pain and Discomfort: Pain and discomfort may be experienced in the surgical area after the surgery.
- Urethral Erosion: Although it is rare for the tape to damage the urethra and cause erosion, is possible.
- Difficulty in Urinating: Some patients may experience temporary or permanent difficulty in urinating after surgery.
- Loosening or Shifting of the Band: It is possible for incontinence problems to reoccur due to loosening or shifting of the band over time.
How is TOT Surgery Care Performed?
- Rest: It is important to rest and avoid strenuous physical activity after surgery.
- Hydration: Drinking plenty of water helps prevent urinary tract infections.
- Medication Use:Antibiotics and painkillers recommended by the doctor should be used regularly.
- Regular Check-ups:Regular doctor check-ups after surgery are important for monitoring the healing process and early detection of possible complications.
Conclusion
TOT surgery is an effective and reliable treatment option for patients with stress urinary incontinence. With its minimally invasive nature, high success rate and relatively low risk of complications, TOT surgery offers a suitable solution for many women with urinary incontinence. As with any surgical procedure, it is important for patients considering TOT surgery to consult with an experienced urologist or gynecologist to learn more about the benefits and risks of this procedure.
Patient Questions and Answers
Question: What is urethral sling (TOT) surgery and how does it work?
Answer: Urethral sling (TOT) surgery is a surgical procedure performed to treat stress urinary incontinence. This surgery prevents urine leakage by placing a band that supports the urethra. The tape is placed under the urethra and provides support by passing through the muscles in the groin area.
Question: Who can have TOT surgery?
Answer: TOT surgery is generally suitable for women who have problems with urinary incontinence during coughing, sneezing or physical activity. It can also be performed for patients with urethral hypermobility and those who have not been successful with previous conservative treatments.
Question: How long does TOT surgery take?
Answer: TOT surgery usually takes between 30-45 minutes. The duration of the surgery can vary depending on the patient's condition and the surgeon's experience.
Question: How long will I need to stay in the hospital after TOT surgery?
Answer: Most patients stay in the hospital for 1 day after TOT surgery. This period may vary depending on the complexity of the surgery and the patient's general health.
Question: How long will it take to recover after TOT surgery?
Answer: The recovery period varies from person to person, but patients can generally return to normal activities within 2-4 weeks. It is recommended to avoid strenuous physical activities during this period.
Question: Will urinary incontinence completely stop after TOT surgery?
Answer: The vast majority of patients experience a significant improvement in urinary control after TOT surgery. However, some patients may continue to have minimal incontinence. The success of the surgery depends on the patient's condition and the surgeon's experience.
Question: How will my sexual life be affected after TOT surgery?
Answer: TOT surgery generally does not affect sexual function. However, it is recommended to avoid sexual activity during the recovery period after surgery. If you experience any problems, it is important to consult your doctor.
Question: What activities should I avoid after TOT surgery?
Answer: You should avoid heavy lifting, exercise, and sexual activity for 4 weeks after surgery. You should also make sure to rest for the amount of time recommended by your doctor.
These questions and answers can help patients learn more about urethral sling (TOT) surgery. It is always important to consult a specialist for more detailed and personalized information.