Trans-Obturator Sub-Urethral Sling
It is estimated that urinary incontinence affects about 13 million American women every year. Women who are affected often experience accidents of urinary leakage when they laugh, cough, sneeze, or, in more severe cases, when they walk. Despite their impact on the affected individual’s quality of life, most of these conditions are often untreated.

Traditional methods of surgery result in a large abdominal scar, significant blood loss, and a prolonged recovery period. With the advances of new surgical equipment and microsurgical techniques, the procedure is now performed in about thirty minutes with minimal scarring and pain.

Trans-Obturator Tension-Free Vaginal Tape (TOT) placement is a vaginal procedure usedto correct stress urinary incontinence and a disorder called intrinsic sphincter defect. A synthetic mesh tape is placed under the bladder neck. This tape functions as a “hammock” supporting the urethra in times of stress, such as coughing, sneezing, laughing, jumping, etc. When properly performed, TOT results in an 86-95% success rate.

TOT may be done under general, regional (spinal or epidural) or local anesthesia. TOT requires only three tiny incisions: aone-inch vaginal incision (under the urethral opening) and twoone-fifth inchperineal incisions. If not performed with other procedures, patients may go home the same day. The procedure takes 20-30 minutes, requiring only a few days of recovery to go back to light duty (office) work and about two weeks for all other activities.

What is neurostimulation?
Bladder function is regulated by a group of nerves at the base of the spine called the sacral nerve plexus. By stimulating these nerves through gentle electrical impulses (neurostimulation), your bladder activity can be changed. One way to stimulate these nerves is to surgically implant a stimulator in your buttocks to send continuous impulses to the sacral nerve plexus. Another way to stimulate these nerves is with Urgent PC, an office-based, minimally-invasive treatment for urinary urgency, urinary frequency, and urge incontinence.