Trans obturator tape

In some people, stress incontinence does not sufficiently improve with the other more conservative treatments and that is when you may wish to consider surgery. Every person is different, and a surgeon will be able to discuss with you what exactly is causing your problem, and how surgery may help. Whatever your particular condition, it is important to really think through the pros and cons of having surgery.

If your doctor or nurse refers you to see a surgeon, then this is an ideal time to ask lots of questions. Ask your doctor as many questions as you want, and never be afraid to go back or telephone to get more information or a clearer explanation. Before meeting the surgeon it may help to note down your questions on a piece of paper, so you don’t forget what you wanted to ask. Make sure you write down the answers you are given; it’s easy to come out of a consultation and forget what has been said.

At any stage of the process if you are not clear about anything the doctor or surgeon says, ask them to explain again, a bit slower this time. The surgeon can also explain why they consider one operation particularly suitable for you.

The Trans Obturator Tape (TOT) procedure is similar to a Tension Free Vaginal Tape (TVT) procedure.  It may be easier or safer to do than TVT in some patients, as the tape is further away from the bladder and the lower abdomen (tummy). In the short and medium term however, it seems to be as safe and as effective as TVT.

The TOT tape is inserted through 3 small cuts, one in the vagina, and one in each side of the upper inner thigh. A cystoscope (a small telescope) is sometimes inserted into your bladder to check for abnormalities and to ensure that your bladder and urethra have not been injured.

This approach is often used when urgency if more of a problem than stress leakage.

If you would like more information about this procedure, please make an appointment with your GP who can discuss options with you and refer you to a consultant as appropriate.