Transobturator Tape Sling (TOT)

A bladder sling, specifically the transobturator tape (TOT) sling, is a surgical procedure used to treat stress urinary incontinence (SUI) in women. SUI is the involuntary leakage of urine during activities that increase abdominal pressure, such as coughing, sneezing, or exercising.

How the TOT Procedure Works

The sling is inserted through small incisions in the vaginal wall and exits through the inner thigh/groin area or obturator foramen, avoiding the retropubic space (behind the pubic bone).

The approach reduces the risk of bladder or bowel injury compared to traditional retropubic slings (TVT).

Benefits of the TOT Sling

  • Minimally invasive

  • Quick recovery, often same-day or next-day discharge

  • High success rate for treating stress urinary incontinence

  • Less risk of bladder perforation than retropubic slings

  • Performed under local or general anesthesia

Recovery

  • Most women can return to light activities within a few days, avoiding heavy lifting and strenuous activity for 4-6 weeks

  • Some may experience mild groin pain or discomfort temporarily

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