TOT (Transobturator tape)

Transobturator tape (or TOT for short) was comparable to an surgery called Tension-free Vaginal tape (TVT). The purpose of TOT and TVT is to treat the condition with which you have been diagnosed, namely, stress urinary incontinence (SUI).The way the tape is inserted and fitted is different in TOT. TOT safer due to there being less chance of injury to your bladder, bowel or blood vessels as the tape is inserted. TOT is a form of keyhole surgery which means that the operation can be performed as a day case procedure and usually is associated with a quick recovery. On average the whole surgery will be done about 30 minutes from the start of the anaesthetic till the time you wake up.

When the muscles and tissues in patient’s pelvis were not strong adequate to hold the bladder it can lead to the urinary incontinence (leaking). This procedure “slings” the bladder back into position and in so doing, stops the leaking. The success rate of the surgery is about 85 percent.


  • TOT Procedure will provide support to the bladder by keeping a synthetic mesh (which will acts as a sling) beneath the mid-portion of bladder neck (urethra) by a small incision or cut in the vagina.

  • The mesh was then passed through a tunnel formed around each side of the bladder neck & out by the thigh fold by 2 small skin incisions.

  • The operation was done through the vagina. Cystoscopy (will helps to visualize inside the bladder with a camera) was done to make sure the bladder and urethra are intact.

  • This procedure was an outpatient method & can be performed under spinal anesthesia.

The main side effect of TOT was finding it hard while passing urine afterwards. This affects about 1 in 20 women. This can result in the need to have a temporary urethral catheter that will allow the bladder to empty till it recovers. A small proportion of women can have a more serious degree of difficulty in emptying the bladder.