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Incontinence Sling Thailand (TVT-O or TOT technique) –Techniques Makes the Process Successful!


What are the processes for the problem?

The incontinence sling can be classified into various types but there are three main types such as:

· Stress

· Urge

· Overflow

These types of problems are occurring from certain activities like coughing, sneezing, laughing, or exercise, and most commonly reason by weak pelvic floor muscles. The websites of Thailand are providing millions of solution so patients can detect right problem from categories of incontinence sling so that the patient can have the right solution to solving problem in a positive manner.  In this way, for rising stress incontinence in women, sling process such as tension free TVT sling, TOT sling, and Mini sling processes are available overseas. On another type of process for stress incontinence treatment offered abroad is bladder neck suspension process which involves Marshall Marchetti Krantz procedure.

Over past 12 years TVT procedure has also revolutionised treatment of the stress incontinence, as well as given good results. The complications are rare & in most of the cases this has stayed proven treatment of option. Prior to, reading this page I will suggest reading TVT page to get background on this, established, successful as well as main technique, just by clicking on a link.

What then are TVTO & TOT ? Why change successful technique?

During the conventional TVT we make two small cuts at a bottom of tummy just above bone & pass tape behind bone & in front of bladder as it is shown below. Later French & Belgian surgeons were all responsible to develop technique further. The approaches make use of similar tape & principal, however instead of passing tape behind bone & upto abdomen, tape is passed from vagina to two incisions to side of a vagina, at a top of thigh. The alternative is passing tape from incisions in vagina. End result of both is also shown schematically in two diagrams below.

There are many current designs, two of which make use of almost identical tape to TVT (TVTO and Monarch (TOT)); these are designs that I use & find most effective. There is not any reason to suppose identical tape can produce surprises in practice & indeed in 970 cases it is safe & effective. Advantages look to be quicker recovery rate, and less chance to disturb bladder, ease of adding to some other prolapse surgery & fewer possible complications like difficulty emptying bladder & bleeding. It should get stressed however complications are all minimal with conventional TVT. Down side however is follow up to date is much shorter with lesser operations done.



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