An Evaluation of Use of Trans-Obturator Tape (TOT) Sling Procedure in the Current
Abstract
Objective: To assess the role of TOT sling procedure in current surgical management of female
Stress Urinary Incontinence (SUI) in terms of post-operative results, cost effectivenss, pt
acceptance and complications.
Method: From June 2006 to September 2008, 30 patients of SUI were treated surgically by TOTsling
procedure. Pre-operatively the patients were evaluated by thorough history taking, clinical
examination and different diagnostic test depending upon the individual clinical scenario.
Patients were explained in their own language the nature of procedure and the principle behind it.
Any complication(s) (intra/postoperative) were noted. After discharging the patients they were
followed up by atleast 3 visits (follow-up visits) at 1, 3 & 6 month interval. Any complications of
the procedure and patient acceptance were evaluated at each follow-up.
Results: The mean age of the total patients (n=30) was 39.5 yrs and 28 (93.33%) were
multiparous. Involuntary loss of urine on straining was the most common complaint present in 25
(83.33%) patients and 22 (73.33) patients were having duration of symptoms less than 3 yrs. 9
(30%) patients were having mild cystocele pre-operatively which resolved after surgery. All the
30 (100%) patients were continent post-operatively while 7 (23.33%) were having lower urinary
tract symptoms (LUTS). No major intra/post-operative complication was seen but, urgency,
dysuria, fever and haematuria was seen post-operatively which resolved after few days. The
operative time was 24 + 3.8 months and catheter was removed on 2.7 + 1.7 days post-operatively.
Hospital stay was 6 + 2.4 days (3 – 11) and app. Cost of the treatment was Rs3253 + 360
(2700,3900).
Conclusion: TOT Sling procedure is currently the Gold Standard for management of female SUI.
It is very important to diagnose SUI and rule out other causes of incontinence because only the
former one (Genuine SUI) is improved by TOT sling and other types may be even worsened by
this procedure.
Key Words: Assessment, TOT Sling, Efficacy, Post-op results, Cost effectiveness, Patient
acceptance, Complications.
Stress Urinary Incontinence (SUI) in terms of post-operative results, cost effectivenss, pt
acceptance and complications.
Method: From June 2006 to September 2008, 30 patients of SUI were treated surgically by TOTsling
procedure. Pre-operatively the patients were evaluated by thorough history taking, clinical
examination and different diagnostic test depending upon the individual clinical scenario.
Patients were explained in their own language the nature of procedure and the principle behind it.
Any complication(s) (intra/postoperative) were noted. After discharging the patients they were
followed up by atleast 3 visits (follow-up visits) at 1, 3 & 6 month interval. Any complications of
the procedure and patient acceptance were evaluated at each follow-up.
Results: The mean age of the total patients (n=30) was 39.5 yrs and 28 (93.33%) were
multiparous. Involuntary loss of urine on straining was the most common complaint present in 25
(83.33%) patients and 22 (73.33) patients were having duration of symptoms less than 3 yrs. 9
(30%) patients were having mild cystocele pre-operatively which resolved after surgery. All the
30 (100%) patients were continent post-operatively while 7 (23.33%) were having lower urinary
tract symptoms (LUTS). No major intra/post-operative complication was seen but, urgency,
dysuria, fever and haematuria was seen post-operatively which resolved after few days. The
operative time was 24 + 3.8 months and catheter was removed on 2.7 + 1.7 days post-operatively.
Hospital stay was 6 + 2.4 days (3 – 11) and app. Cost of the treatment was Rs3253 + 360
(2700,3900).
Conclusion: TOT Sling procedure is currently the Gold Standard for management of female SUI.
It is very important to diagnose SUI and rule out other causes of incontinence because only the
former one (Genuine SUI) is improved by TOT sling and other types may be even worsened by
this procedure.
Key Words: Assessment, TOT Sling, Efficacy, Post-op results, Cost effectiveness, Patient
acceptance, Complications.
Khan, F. N., Hamid, A., Wazir, B. S., Wani, M. S., & Ahmad, Z. (2008). An Evaluation of Use of Trans-Obturator Tape (TOT) Sling Procedure in the Current. International Journal of Health Sciences, 2(2). Retrieved from https://ijhs.qu.edu.sa/index.php/journal/article/view/56
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