Stress incontinence surgery in İzmir

What is stress Incontinence Surgery (TOT and TVT Slings)?

Incontinence surgery is done most often for stress urinary incontinence. In this type, urine leaks when pressure in the abdomen rises, during coughing, laughing, sneezing, running or heavy lifting. The cause is usually a pelvic floor and supporting tissues around the urethra weakened by childbirth and age. Today the most common method is the mid-urethral sling, a thin, porous tape placed through the vagina under the middle part of the urethra: when the tape passes behind the pubic bone it is called TVT, and when it passes towards the inner thigh it is called TOT; there are also mini-slings with a shorter tape. For women who do not want a synthetic tape, a sling made from their own muscle sheath or an abdominal Burch operation are options. A sling does not help leakage with a sudden urge to pass urine (urge incontinence) and can even make it worse, so the type of leakage must be identified before surgery. Patients should also be told that some countries have restricted synthetic tapes and that debate continues.

How is stress Incontinence Surgery (TOT and TVT Slings) done?

1. A detailed history, bladder diary, urine test and gynaecological examination; showing the leakage with a cough test
2. Urodynamic testing in mixed or unclear cases
3. Trying non-surgical treatments such as pelvic floor exercises first
4. Placing the tape through a small cut in the front wall of the vagina under spinal anaesthesia, sedation or general anaesthesia
5. Checking the bladder, the ability to pass urine and the amount of urine left in the bladder

Who is stress Incontinence Surgery (TOT and TVT Slings) suitable for?

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