Urinary Incontinence Tot Surgery

What is TOT?

TOT, known as Trans Obturator Tape, is a type of operation performed from the vaginal area. In this operation, hooks are inserted from the sides of the pelvis. After entering inside, a patch is placed on this area. The patch is placed under the point called the urethra, which plays an important role in the transport of urine out of the body.

TOT is popularly known as urinary incontinence operation. It is the first option that comes to mind especially in stress urinary incontinence. It can be performed with different techniques such as spinal anesthesia or sedation with an operation that requires 1 day of hospitalization.

Spinal Anesthesia: It is a type of anesthesia that is frequently applied in cesarean deliveries. It is made by passing the spinal cord through the bones of the spine and means completely numbing the lower part of the body. It can also be used in TOT surgery.
Sedation: It is putting the patient to sleep with the use of drugs. Activities such as eating and drinking should be terminated 2 hours before this technique performed by the anesthesiologist.
TOT, which is applied to people who have urinary problems and who constantly leak urine, can be done to everyone, regardless of male or female. In this operation, which is a very simple method, the patient can return to her daily life in a short time.

Types of Urinary Incontinence

Urinary incontinence can be seen in men and women for different reasons. According to their causes, these disorders are grouped under the following headings:

Stress Incontinence: It is the urinary incontinence seen in women who have gone through menopause. It can be seen in most women, especially after menopause, which occurs after a certain age. In this case of urinary incontinence, it can be seen that urine escapes after movements such as standing up suddenly, laughing suddenly, and lifting heavy.
Impingement Type Urinary Incontinence: Patients whose bladder is not full may experience urgency all of a sudden. This can be seen in people with urinary tract infections and people suffering from Alzheimer's and Parkinson's.
Overflow Incontinence: Some people may not feel how full their bladder is. In such times, urinary incontinence is the most common condition after sudden movements.
Total Incontinence: If the patient is constantly leaking urine day or night, regardless of whether the bladder is full or empty, the name of the disease is known as total incontinence.
Mixed Type Incontinence: In this disorder, urinary incontinence is observed for a while due to stress and urge type disease.
TOT Surgery

TOT Surgery is a successful method that has been applied to people with Urinary Incontinence (urinary incontinence) since 2001. Before the operation, the doctor should be discussed in detail. Because TOT is done not only for men, but also for women. In women, situations such as childbirth should not be considered after this operation. It is important to evaluate this style and other personal conditions with the doctor.

TOT undergoes an operation that will take an average of 30 minutes. However, this process may be prolonged due to the desire to treat some other ailments. During the operation, the following stages are recorded:

The patient is primarily anesthetized with the anesthetic method. These may be the spinal anesthesia or sedation method described above.

The operation begins with a thin incision in the vaginal tract of the patient on the operating table.
Then, a band called polypropylene mesh, which is used as a patch, is placed under the patient's urethra.
A needle specially designed for this operation is used to place the tape.
Then the incision is closed and the patient's operation is terminated.
The hospital stay of the patient in the TOT operation is usually limited to 1 day. Therefore, the patient can return to his normal life in a short time.

TOT Surgery Advantages

TOT surgery is a very successful operation due to its performance, speed and near-perfect result. The main advantages of this surgery are as follows:

The healing of the cuts opened during the surgery is very fast,
Although the hospital stay is not often, in some cases, hospitalization can be seen. This situation is limited to 1 day.
Postoperative complications and other side effects occur very rarely. For this reason, the occurrence of complaints after the operation is generally not seen.
The success rate of the surgery is quite high. The operation is successful at a rate of 62% - 81%.
The probability of the condition recurring after the operation is close to zero.
TOT surgery is an effective treatment method for this condition, such as urinary incontinence, which adversely affects the social life of the person. With the successful completion of this operation, the patient's discomfort can be completely relieved.

Things to Do After TOT Surgery

After every big or small operation, some things need to be considered. Although TOT may seem like a minor operation, there are some minor details that need attention in this operation. These are the details:

It is necessary to pay attention to the hygiene of the surgical area.
It is important to regularly use the medicines prescribed by the doctor.
After the operation, you should definitely go to the doctor's control and this should not be delayed.
After the operation, great attention should be paid to heavy lifting and other elements that will force the body, during the process until the stitches are removed or melted. This process can take up to 1 month on average.
After the TOT operation, the patient should not take a bath for 1-2 days.
After this operation, sexual intercourse should not be performed in the first 1.5 – 2 months.
These are the things that should be considered after the operation in general. However, it is seen that some additional measures are taken, which will be given by the doctor, and in some cases, based on the past ailments of the person.

TOT Surgery Success Experiments

Before an operation becomes widespread all over the world, they are subjected to a number of experiments to investigate possible side effects and other conceivable factors. The results from these experiments are as follows:

In the experiments conducted to measure the relationship of the TOT operation to sexuality, it was stated that 18 of the 20 sexually active patients out of 42 still continued their sexual life actively after the operation, and the others could not continue their sexual life due to different reasons.
In this operation, which is known as coital incontinence and performed on 12 people with urinary incontinence, it was observed that the complaints of 11 people ended, but the complaint of one person continued due to sling erosion.
With the successes achieved after these experiments, the TOT operation has started to spread rapidly around the world.