Transobturator tape (TOT) for female urinary stress incontinence

11-06-2020
Stres urinarna inkontinencija

At the Atlas General Hospital, Dr. Sladjana Kovacevic, urology specialist, successfully treats stress urinary incontinence. One way to solve this problem is TOT transobturator tape treatment. Urinary incontinence is the loss of voluntary control over the muscles urinary sphincters and it is a symptom, not a disease. Mostly, we associate this symptom with older age, but there are also younger women who suffer from this problem. Before entering the operating room, Dr. Sladjana Kovacevic explained what the intervention we call TOT – transobturator tape consists of.

TOT transobturator tape

Dr. Sladjana Kovacevic: ” It is a tape that is implanted in women who have the problem of stress urinary incontinence, or involuntary urination. We performed a cystoscopy on the patient, prepared it completely diagnostically and concluded that the patient is an ideal candidate for this intervention. ”

Dr. Sladjana Kovacevic reminds what the symptoms that lead to very unpleasant conditions are. The problem can be solved with this intervention, after which women regain their self-confidence and lose their discomfort.

Dr. Sladjana Kovacevic: ” This symptom in women is mainly manifested when coughing, sneezing, and running. Patients cannot suppress urination, they wear pads during the day and sometimes, when it is a more difficult case, it happens that there is involuntary urination during walking. These are all situations for which the only solution is surgery. In these cases, conservatives, drugs, Kegel exercises, electro stimulation do not help, that is, everything that may even be preventive or helped in milder cases, but not in more severe cases where surgery is the only solution. ”

Transobturator tape (TOT)

TOT  transobturator tape treatment is very safe. It is short-term treatment and can be performed under all types of anesthesia. The success of resolving stress urinary incontinence with these surgical techniques is very high.

Dr. Sladjana Kovacevic: ” For the patient, in essence, this type of operation is a minimally invasive procedure. We make an incision of a centimeter and a half below the ureteral ostium on the vagina and prepare the tissue next to the urethra. We pass special needles through the obturator foramen, which is one of the critical points of the operation, and then we pass the tape. We dose how we will put it, how much we will fix it, that is, tighten it. After that, the patient stays in the hospital for one day, with a urinary catheter and one gauze (swab) soaked in iodine.

The next day, it is all removed and the patient can go home. It is very important that the patient rests at home after the intervention and is disciplined in terms of minimal physical activity.

For the first seven to ten days, the patient must not make any movements that expand the pelvis, because the tape also expands. Some full postoperative course is six weeks. In those 6 weeks, the patient can go for a light walk, but there are no squats, lifting heavy loads, sexual intercourse. After 6 weeks, everything returns to normal. ”

TOT treatment for stress urinary incontinence

Can TOT gives some kind of discomfort with all precautions taken?

Dr. Sladjana Kovacevic: ” Very rarely. In studies done in America, there is a certain percentage that is very small, and it refers to the fact that the tape for women represent some discomfort. But that is really very rare. In general, patients tolerate the intervention well, are very satisfied, dry and the quality of life is totally different. ”

Besides this surgical intervention, the Atlas Hospital performs an intervention as a solution to the problem of urinary incontinence which is easier than the one we are talking about. It involves the injection of a special substance or type of gel, which is an excellent solution for certain groups of patients who are not recommended to apply the tape.

Dr. Sladjana Kovacevic:Hydrogel injection is very easy, because it is completed within 10 minutes. The patient is previously given local anesthesia. This method is completely comfortable, there is no pain, but we must mention that there is a certain percentage when we have not completely solved the stress of urinary incontinence with the gel. This method is very appreciative for elderly patients, because of the comorbidity. They are treated for various diseases and therefore it is not safe to introduce them into anesthesia, because it might be harder to endure the operation itself. This method is phenomenal for them. For young women who want to give birth, tape is out of the question. For them, hydrogel is a solution that will restore their quality of life. There is a group of patients who are very closely selected for this type of treatment. ”

How many women know about this intervention and how often do patients come for a check-ups?

Dr. Sladjana Kovacevic: “Patients are coming more and more often, but few women know about this intervention. This is like a “taboo topic” in our country, because a lot of women have problems with stress urinary incontinence, and little is said about it. There are solutions, they are very elegant and very successful, which is the most important thing. I think the more we talk about it, the more women are encouraged to come forward and solve the problem. ”

We are talking about this topic. If you talk about your problem, you will find out that there is a solution. You can live a quality life again and without fear of discomfort.

You can see the whole article HERE.

If you have discomfort and feel mostly uncomfortable due to urinary incontinence, call the Atlas Hospital call center on 0117858888 for any additional information.