TOT TVT for Urinary Incontinence Expertise of Dr. Yasir Iqbal

TOT (Transobturator Tape) and TVT (Tension-free Vaginal Tape) are both surgical procedures used to treat stress urinary incontinence (SUI) in women. These techniques involve placing a supportive mesh tape under the urethra to help prevent leakage during activities like coughing, sneezing, or exercising.

🔍 What Is Stress Urinary Incontinence (SUI)?

Stress urinary incontinence is the involuntary leakage of urine during physical activities that increase abdominal pressure. It commonly affects women after childbirth or menopause due to weakened pelvic floor muscles or urethral support.

⚙️ How the Procedure Works

1. Anesthesia: Usually done under local, regional, or general anesthesia.

2. Incision: A small vaginal incision is made under the urethra.

3. Tape Placement:

   • TVT: Tape goes from the vagina to the lower abdomen (retropubic route).

   • TOT: Tape goes from the vagina out through the groin (transobturator route).

4. Support: The tape acts like a hammock, supporting the urethra during stress events.

5. Closure: Incisions are closed; the tape is left in place without tension.

📈 Success Rates

• Both procedures have 80–90% success rates at 5–10 years post-op.

• Choice often depends on patient anatomy, prior surgeries, and surgeon experience.

⚠️ Risks and Complications

• Infection

• Tape erosion

• Urinary retention

• Groin/thigh pain (TOT)

• Bladder perforation (TVT)

👩‍⚕️ Who Should Consider TOT/TVT?

• Women with confirmed stress urinary incontinence

• Those who have failed conservative treatments like pelvic floor exercises

• Patients seeking long-term solutions to SUI

📝 Summary

TOT and TVT are both minimally invasive, effective treatments for stress urinary incontinence. While TVT is slightly more invasive with a higher risk of bladder injury, TOT may offer fewer complications with similar outcomes. The right choice depends on the patient's anatomy, preferences, and the Dr Yasir Iqbal's expertise.